Last month, we explained how cutting funding for poison centers is a classic case of ‘penny wise, pound foolish’ and the loss of poison centers would lead to a drastic increase in unnecessary health care costs. One of our astute readers left us a comment asking a very good question:
Thanks for this explanation. I am a big believer in what you guys are doing. There is no doubt that Poison Centers across the country save a lot of money (as well as lives!)
Nonetheless, I do think more explanation is needed to address why a national (or regional) poison centers wouldn’t work. I know local relationships are important, but in my opinion, this needs to be explained further.
We are so glad you asked (we also really like the compliment on saving money and lives too!). We understand the federal government needs to save money, and that a suggested solution is to consolidate the current 57 national poison centers into one, single national poison center to handle all the calls in the country. While that might seem like the best idea, it is however, not a well thought-out concept. There are many reasons why, but the biggest one is…
It would cost the federal government more to have a single center. $100 million dollars more, to be exact.
- Federal funding for poison centers, on average, amounts to less than 20% of the total cost of service for a poison center. Each poison center is funded differently, but is usually a mix of federal, state and private support (including hospital contributions and donations). Since state and non-profit donations have to stay within the designated region they serve, one big national center means Uncle Sam would have to foot the WHOLE bill.
- Poison centers are accustomed to scrimping and saving. Here at the IPC we have just enough staff members to handle our annual call volume of over 90,000. Even at our current staffing level, some callers still end up waiting on hold for a minute or two. If any one center had to take on the burden of the current annual national call count of over 4,000,000, that center would have to hire an estimated 700 nurses/pharmacists just to man the phones. Now add a commensurate number of IT folks, medical directors, managers, another few hundred computers, phones and other infrastructure and equipment.
- The notion of a single national poison center makes the federal expenses, as well as the size of government bigger, which is the opposite of the initial intent of the national center concept.
Even IF the federal government had an additional $100 mil to spend on a poison center (which they clearly do not), there are a host of additional reasons why one big poison center is not the best solution. Here are the other 5:
1. Professional education will suffer
- The Illinois Poison Center, like many others nationwide, is our state’s leading source of toxicology training for healthcare professionals. We train hundreds of pharmacy and medical students and residents each year. We also provide continuing education for practicing professionals on emerging poisoning threats and state- of- the-art treatments. How is one poison center in D.C. (or Chicago, or Atlanta, or New York) going to provide that level of training to the doctors, pharmacists and nurses all over the country? The answer is, it won’t. Poisoning is the second leading cause of injury related death in this country, and having clinicians well-versed in poison management is essential. By consolidating all the poisoning knowledge in one place, it will weaken the education of those who will take care of our healthcare needs in the future.
2. Public education will be ineffective
- A large part of our poison center’s mission is providing public education and outreach—to prevent as many poisonings as possible from happening in the first place. Even though our call center is located in Chicago, we perform many outreach and education events all over the state. In 2010, 1,729 IPC events were held in the state (reaching over 319,000 people). The Illinois Poison Center serves the largest population of any of the poison centers, and let me tell you, it is challenging to reach so many people in such a large geographic area. How is one single poison center going to be able to provide public education and awareness to the entire country to prevent poisonings in the first place? Again, the answer is, it won’t.
3. Level of service will decrease
- The local relationships poison centers have with hospitals, clinicians, and local health departments are invaluable. These relationships would disappear with one national center, along with knowledge of each regions’ hospital capabilities and antidotes supply, and emergency response systems.
- The level of toxicology expertise in the brains of all of the poison specialists at the 57 poison centers nationwide is truly amazing. Many have decades of experience and tens of thousands of managed cases under their belt. Most of that would be lost, since these experts are not all in one geographic area.
4. Regional toxins
- God Bless America. “From the mountains to the prairies, to the oceans, white with foam”. In the poison world, the song may go more like this: “From the rattlesnakes, to the berries, to the scorpions and mushrooms domed’. As different as each region of the country is in topography, weather and sports team affiliation, there are different natural toxins. We have toxic mushrooms here in Illinois that they do not have in Arizona. Arizona has toxic scorpions that they do not see in Maine, Maine has toxic plants they do not see in Florida. Florida has toxic snakes…well, you get the idea. Poison specialist expertise on these toxins AND their antidotes can save lives.
5. Disaster Preparedness
- The IPC is heavily involved in regional disaster preparedness. An example is our agreement with the City of Chicago to manage the hospital antidote stores for the city in the initial hours of a chemical nerve agent attack. We are not the only center with such arrangements. How will a single center manage the storage lists, movement and transport of critical supplies for the third largest city in the US when they won’t know the difference between Lincoln Park, Humboldt Park and Jackson Park? It won’t.
The current multi-center national network really works, and maintaining funding is crucial.