Providence Health blindsided patients, employees and providers last week, announcing that it would no longer offer outpatient laboratory services at its California hospitals — including St. Joseph and Redwood Memorial — beginning March 18.

Local providers reportedly first received a text message Jan. 10 informing them that outpatient lab services would no longer be provided at Redwood Memorial Hospital in Fortuna, followed by another about an hour later announcing the service would be discontinued at hospitals throughout the state. According to employees and providers, the decision was reportedly made with little — if any — local consultation or warning.

A wide swath of patients depend on the outpatient services to get blood work done for a broad variety of reasons, from regular tests to help guide the chemotherapy regimens of cancer patients to diagnostic testing to determine the course of treatment for a respiratory illness and whether a patient might require hospitalization.

"It's a critical decision that's going to affect how we do work," says Donald Baird, a former Humboldt County public health officer who has practiced as a physician locally for more than 40 years, currently as a physician for Open Door Community Health Systems in Ferndale. "It places one more burden on an already overburdened workforce."

Christian Hill, a spokesperson for Providence in Humboldt County, said the decision followed a "thorough assessment" and is aimed to "help us focus on our strengths of delivering care and partnering with other organizations whose primary business is lab services."

Hill added that the decision will not result in any layoffs, saying employees currently supporting outpatient lab services will be retained.

"Providence recognizes the importance of laboratory services for members of our community," Hill said in an email. "We did not enter into this decision lightly and are confident that other providers of these services will be able to support our community's future needs."

Hill did not respond to follow-up questions regarding what other providers are expected to fill the outpatient laboratory services void the decision will create or how many samples are taken and tested through the two hospitals' existing services. There is wide speculation that LabCorp — a multi-billion-dollar national company based in North Carolina that processes more than 2.5 million samples weekly at 36 laboratories — may open a local blood draw site, but the company did not respond to inquiries about its plans by the Journal's deadline. Additionally, even if the company were to open a draw site locally, it would likely still send samples out of the area to be tested, meaning slower turnaround times for patients and providers to get results.

Local lab services are available at Jerold Phelps Hospital in Garberville and Mad River Community Hospital in Arcata, as well as on a limited basis through Open Door Community Health for its patients, but discontinuing the service at Redwood Memorial and St. Joseph may leave two of Humboldt County's largest population centers without a laboratory that processes samples from the general population locally.

And that's far from insignificant, according to Baird. While in many cases, Baird says patients and providers can wait the average 48-hour turnaround time to get results from an out-of-area lab, samples can be damaged in shipping, introducing inefficiencies to the delivery of care. But more troubling, Baird says, are the cases where prompt lab results are crucial.

In the case of cancer patients getting regular chemotherapy treatments, Baird says blood work is crucial in guiding their care and sometimes providers need test results within hours of administering treatments, which is difficult if not impossible to coordinate with an out-of-area lab.

More troubling, he says, are the acute cases. Imagine, he says, a 72-year-old man goes to his doctor with a cough and fever, and underlying obstructive pulmonary disease, having been sick for a week. Baird said the patient's provider would order a chest X-ray and a complete blood count test to determine if the man has pneumonia, which would require hospitalization, but couldn't wait 48 hours for the blood work. Absent outpatient lab services that could deliver prompt results, Baird says the man would be sent to the emergency room — a potentially avoidable visit that would necessitate the man waiting for hours to be seen, tying up emergency resources and leaving the patient saddled with ER bills that could total more than $2,500.

Vicky Sleight, a spokesperson for Mad River Community Hospital, says the hospital has a full lab on site that can handle almost all tests, only rarely having to send samples out of the area for very specialized testing. The lab, she says, has the capacity to accommodate an increased patient load when St. Joseph discontinues the service, adding the lab could expand hours if needed. With some patients concerned about the insurance impacts of having to switch lab service providers, Sleight says Mad River is always able to work with patients facing financial hardships.

Similarly, Jerold Phelps Hospital in Garberville offers walk-in outpatient laboratory services seven days a week, from 8 a.m. to 5 p.m. Open Door, meanwhile, provides outpatient lab work for its patients, but only does limited testing on site, sending anything beyond basic testing out of the area to various labs, including LabCorp.

Open Door President Tory Starr says LabCorp has provided "excellent service," and says he expects it or another company would be "eager to fill the market niche" left by Providence's decision and could possibly provide similar services at lower prices.

Redwood Urgent Care opened a fully accredited outpatient laboratory in 2017. It closed in May of 2022, but not before its owner Wahidullah Medical Corp filed a federal unfair business practices lawsuit against St. Joseph Health in 2018. The suit accused St. Joseph of illegally conspiring to stifle competition to maintain alleged 10-fold markups on lab services. The suit was settled out of court in 2018.

In an interview with the Times-Standard, Caroline Conner, a physician who serves as the secretary-treasurer of the Humboldt-Del Norte Medical Society, said Providence's decision to shutter outpatient lab services across all California hospitals will have an outsized impact in rural areas, which have fewer alternative providers than someplace like Santa Rosa.

For his part, Baird says the lack of a local outpatient lab option in Eureka and Fortuna will be an inconvenience for many, forcing some patients to take more time out of their days to drive to Garberville or Arcata when they need timely results. And it will add stress to providers, who will sometimes face the uncomfortable choice of sending a patient to an ER visit they may not be able to afford because they don't have enough information to safely treat them on an outpatient basis. But mostly, he says, he feels for Humboldt County's most vulnerable — those with mobility and transportation challenges, and the roughly 20 percent of households who live below the poverty line. Those folks may not have an extra $10 to spend on gas to get from Eureka to Arcata or be able to take the additional time off work.

"The people who can least afford this, those who are most medically disabled and financially compromised — that's who this is going to hurt most," Baird says.

Thadeus Greenson (he/him) is the Journal's news editor. Reach him at (707) 442-1400, extension 321, or [email protected].