The decision to close Tufts Children’s Hospital has triggered a backlash from doctors, nurses, and families mourning the impending loss of a historic and beloved institution and worried that some sick children could lose access to critical care.
Tufts executives said last week that they would close their 41 pediatric beds in Boston by July and convert the space to treat adult patients, while referring children who need inpatient treatment to Boston Children’s Hospital. Since then, thousands of people have mobilized in opposition to the plan to shut the 128-year-old pediatric hospital, formerly known as the Floating Hospital for Children.
The decision means patients such as 4-year-old James Lino, who is in treatment for lymphoma, will have to switch to a new hospital and new care providers while contending with serious illnesses. James has been sick for nearly two years and has spent 250 nights at Tufts, said his mother, Heather Lino.
“You hear it will be a smooth transition, and I’d like to believe that, but I don’t think that is possible,” she said. “You’re talking about thousands of children. How is that going to go seamlessly?”
Like other families, the Linos chose Tufts because of the close-knit community of health care providers, who have become attached to her son.
“They just know everything about him,” she said. At Boston Children’s, “It just won’t be the same.”
The announcement has spawned an online petition to save Tufts Children’s Hospital, gathering more than 20,000 signatures in just a few days.
Tufts, compared with Boston Children’s, treats a significantly higher share of patients on Medicaid, the public coverage program for poor and low-income families. And some patients have insurance plans that currently include Tufts, but not Boston Children’s.
Doctors said they’re concerned that patients could lose access to care if their insurance doesn’t include both hospitals.
“We want nothing more than to continue caring for our patients,” said Dr. Melissa Mauro-Small, a pediatric hospitalist who has worked at Tufts for 12 years. She is among hundreds of people who may be forced to look for new jobs in the coming months.
“This felt like a punch in the gut,” said Mauro-Small, who treats children at a Tufts-affiliated program in Brockton. “It really seemed to come out of nowhere.”
Dr. Kyna Donohue, a second-year pediatric resident at Tufts, said patients and families are already “terrified” about losing access to doctors and nurses they’ve gotten to know through years of difficult medical treatments.
“Not knowing what’s going to happen or where they’ll go for care is devastating,” Donohue said, wiping away tears.
“I hope that Boston Children’s will be able to absorb our patient population and all the insurance needs of our patients, but it’s of course a worry.”
Dr. Michael O’Brien, a first-year resident in pediatrics and psychiatry, said the decision “feels like a betrayal.”
“The closing of a children’s hospital in the middle of a pandemic when we’ve been constantly full and when there’s a child mental health crisis goes against everything that we have stated that we stand for,” he said.
The plan to close inpatient pediatric care at Tufts — which still needs approval from state regulators — will also disrupt residency programs for pediatricians in training. Residents can continue their training at Boston Children’s, but Tufts will no longer accept new classes of pediatric residents.
“We call each other the Floating family,” O’Brien said. “Now I feel like my family’s being split apart.”
Several Tufts doctors and nurses said their inpatient units are routinely busy, countering the description from hospital executives who said that pediatric beds often lie empty and should be converted to treat adults, who are facing waits for hospital care.
Dr. Jonah Schey, a pediatrician in Lynnfield who trained at Tufts, said the decision is a “tragedy” and shows that hospital leaders expect to make more money treating adults than treating children.
“There have to be ways to make more space for adult beds other than consuming a children’s hospital,” he said. “It feels so wrong to remove it.”
Tufts’ chief executive, Dr. Michael Tarnoff, said people are leaping to premature conclusions. Tufts leaders are still developing a detailed plan and will include physicians and others in that process, he said.
Tarnoff bristled at the notion that Tufts was abandoning health care for children, noting that the newborn intensive care unit and outpatient services would continue.
Tufts and Boston Children’s are working on a plan to collaborate on outpatient services, but it’s unclear what that relationship ultimately will look like, or whether pediatric specialists at Tufts will find new jobs at Boston Children’s or go elsewhere.
Some children will be able to continue seeing doctors at Tufts outpatient centers, but kids with serious and complex diseases will likely need to shift their care to other providers.
Tufts and its affiliated hospitals and doctors treat about 70,000 patients annually, most of them in outpatient clinics. About 1,900 children were hospitalized and discharged from Tufts last year.
“I understand the difficulty of the situation,” said Tarnoff, who was a surgeon at Tufts for 20 years before becoming CEO. “We only want to do what’s right for everybody involved.”
“We’re working through all of this in real time,” he said. “We’re working quickly.”
Tarnoff said he and Boston Children’s CEO, Dr. Kevin Churchwell, are aware that the two hospitals have different insurance contracts and are “committed to continuity of care.”
Boston Children’s spokesman Paul Donovan said the hospital will address insurance issues as it works out a more detailed agreement with Tufts. “If there are gaps in coverage, we will work with those insurers to cover those children, as we always do,” he said in an e-mail. “Additionally, we have existing processes in place to work with payers when Boston Children’s is out of network and patients require access to our services.”
The work of caring for sick babies and children is emotional, and the staff in pediatric hospitals often develop close bonds with their patients and with their colleagues. That, doctors and nurses said, is why the decision is hitting so hard.
Nurse Mary-Margaret Quinn had just finished her shift on the pediatric medical-surgical floor when she heard the children’s hospital was closing. As she and her colleagues watched the announcement on Zoom, Quinn said, everyone began to cry.
“I know there will be another nursing job that comes along, but I grieve for my patients,” Quinn said. “By closing our doors, we are limiting access to so many that depend on us for care.”
Allison Martineau, a pediatric ICU nurse at Tufts for 19 years, said the news is especially hard given how busy her unit has been during the last several months of the pandemic. Hearing the hospital will close feels like “a death in the family,” she said.
The outpouring of reaction has spilled into a Facebook group with hundreds of members and an online petition launched by Tim O’Connell, founder of Tommy’s Place, a nonprofit that runs a Falmouth vacation home for kids with cancer.
O’Connell has worked with Tufts since 2007. “I’ve been able to see the way that they care, and the way they make themselves available to everybody, including me,” he said. “You can’t teach somebody to care like they do.”
Carol Anne Healy said the staff at Tufts have gone above and beyond for her son, who was born profoundly deaf. She said a surgeon offered to drive back from a planned vacation to perform surgery on her son in 2020, and since then, the staff have always answered her questions by phone and e-mail.
“We’re forever indebted to Tufts,” Healy said. “I could call him and just talk to him as our surgeon. He was never too important or busy. . . . Not to say that’s not possible at [Boston] Children’s, but when you consolidate, how are you going to get that personal patient care and touch?”