California doctors jolted by power crisis

The state's rotating blackouts have left some physicians scrambling to reschedule everything from annual checkups to elective surgeries.

By Kathleen F. Phalen, amednews correspondent. Feb. 26, 2001.

Californians have been on stage 3 power alerts for nearly a month as the state's debt-ridden utilities scrounge for power, hour by hour. If there's not enough, things go black.

Although there is a grid system designed to warn areas of pending blackouts, it's not working so well.

Imagine being a surgeon and losing power in the middle of surgery, or being ventilator dependent and getting cut off while at home alone. More than likely, backup batteries or generators will keep things going for a few hours. But then what?

"We're in a crisis stage," said Brian Roach, MD, an internist and president and CEO of Mills-Peninsula Medical Group in Burlingame, Calif., near San Francisco.

The way Dr. Roach explained it, there's a domino effect. When backup power gets used, there's no backup for the backup. Elective surgical procedures get cancelled. Patients get bumped back.

"By law, it's required that there be backup for at least three hours, and my system is instantaneous," said James Pertsch, MD, a plastic surgeon in San Mateo. Dr. Pertsch's surgery center has already experienced at least one blackout. "But you hesitate to start any elective surgery until the power comes back. So at the minimum our holdup is two hours. And it is quite expensive to run an OR with nurses sitting around and then getting overtime."

Backup batteries for home medical equipment drain, and charging is impossible until power is restored. Doctors' offices go dark, and appointments must be cancelled. Emergency 911 systems get overburdened with nonemergency calls.

"Most phone systems need power, so the doctors' phones are down two or more hours. Can you imagine a doctor without a phone?" asked Dr. Roach. "When my office lost power, we had to close down because we couldn't examine patients. Then rescheduling becomes a real problem; with the shortage of doctors here, where will you put them on the schedule? If this is more sustained, we could be in deep trouble."

Jan Garrett, executive director of The Center for Independent Living in Berkeley, uses a power wheelchair, but she said her situation isn't as bad as others. There's David Freeman, who uses a respirator, and Ron Washington, who sleeps in an electrically operated airbed. When the power goes, his bed deflates. "He'd have to get help right away," said Garrett. "For patients who need these beds, the skin breaks down very quickly."

Although being prepared for a loss of power is critical, it is pretty much left up to the individual. Garrett sees it every day. The people who get help from her center are the ones most affected by unexpected power outages and soaring costs. They have special power needs. And they're often on fixed incomes. But the utilities don't seem to have any workable plans, she said. "They say there is a grid, but it's not right, or the information is not available. And there is a low-income phone line for people to get a rate abatement, but it's always busy or no one answers."

That is why Garrett and her staff are attempting to get the word out. "Education is key," she said. "We actually tell everyone to have supplies on hand, and if they have an at-home attendant, we tell them to make arrangements for a neighbor to check on them if the power goes out in case the attendant can't get there or the phones go dead. ... Public education is key. We need to let them know what their backup options are."

Berkeley's Project Impact, part of a national campaign administered by the Federal Emergency Management Agency as a response to earthquake preparedness, has been in the planning stages for a while, said Garrett. The goal: Charging stations, placed at fire stations around the city, for people dependent on electrically operated equipment like wheelchairs and respirators. "When it's ready, people could come and recharge their batteries at these charging stations," she said.

But backup power isn't always good. A spokeswoman for Mills-Peninsula Health Services said their radiation oncology center does not have a backup for its linear accelerator because the power surge can damage the machine. It's better to have it stop. Although there is no risk to the patient, it's another one of those scheduling issues.

Dr. Roach said an even bigger problem for California is natural gas supplies, which are also at risk because of mounting debt. "Emergency systems, hospitals and 911 are pretty proud of their backup generators, but most are run off natural gas," he said. "If we lose natural gas, too ... there will be no hot water, no heat, no backup power. Energy prices keep going up, people are losing business, revenue is going down. The potential for disaster to the economy is extreme."