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This $3 million, 30,000 square foot Nemours Children’s Clinic in Orlando at 1717 South Orange Ave. replaces the previous Nemours clinic, which opened in 1997.

Nemours unveiled a new $3 million Orlando children’s clinic in January, a month after announcing plans to purchase land for a $400 million children’s hospital in the Lake Nona area of Orlando.

State regulators awarded permission to build the new hospital after two failed attempts at a certificate of need over the past three years. The latest denial came in December 2006 for a site near the Mall at Millenia.

As Nemours’ ambitious plans for Orlando take shape, top executives of Nemours met with competing area hospitals in January to work out an agreement for cooperation. Orlando Regional Healthcare and Florida Hospital each opposed a new children’s hospital in the past.

At the same time, pediatric specialists were both optimistic and cautious of Nemours. Anticipating steep competition for doctors, dozens of physicians have left their jobs at the Nemours Children’s Clinic in Orlando since 2005 in favor of private practice or employment with the two existing area hospitals. The Nemours physician staff, once at around 70 in mid-2005, is now at 26.

Some doctors feel there won’t be enough children’s specialists to staff a third hospital in Orlando by 2012 when the Nemours facility is slated for completion.
Nemours says there will be enough doctors, drawn from mainly outside Orlando, and that a new hospital is important to the metropolitan area.

The 550,000 square-foot, 95-bed hospital will be unique in pediatric medicine, said Jarrod Cady, Nemours spokesman. The new hospital will be located close to the University of Central Florida medical school, the Burnham Institute for Medical Research and a proposed VA hospital.

“We’re trying to establish something really powerful,” Cady said. “The Orlando area has the highest infant mortality death rate in Florida. It has the highest sudden infant death rate. We’re saying we can do better and we should do better.”

Along with research and advocacy, the hospital will treat its patients as a whole child, which includes mental health and lifestyle issues, Cady said.
But several doctors who spoke to Orlando Medical News say that in their experience Nemours is not unique or innovative and that the hospital could actually have a negative impact on children’s healthcare.

“There’s a lot of excitement and a lot of skepticism at the same time,” said Dr. Brian Harris, a pediatrician in Altamonte Springs and president of the Central Florida Pediatric Society. “The excitement is having a state-of-the-art facility and potentially more access to children. The skepticism is the possibility of duplicating care already available, making it difficult to staff three children’s hospitals.”

Nemours is already demonstrating its ability to recruit from outside Orlando, Cady said. The Orlando clinic recently added five new doctors in the past year, all from outside Florida.

“We have no intention of trying to take other doctors away from other facilities,” Cady said. “We’re looking for the absolute best we can find across the country.”

Competition is clearly a concern for both Arnold Palmer Hospital for Children run by Orlando Regional Healthcare and Florida Children’s Hospital operated by Florida Hospital.

So far, Nemours has not decided on specialty areas for its new hospital. But no matter what it chooses, Cady acknowledged, the overlap of some services is inevitable. “When all the dust settles, we want to work in collaboration with the two hospitals,” he said.

A new hospital stands the chance of creating a bidding war among Orlando specialists, warned Dr. Cheryl Cotter, who worked for Nemours at the Orlando and Jacksonville clinic for 10 years before leaving with Dr. James Kosko to start their own practice in October 2006.

“On a whole, that’s a bad thing for society to do, that is, to outbid itself in such a small market as ours,” said Cotter, one of only four ENT specialists for children in Orlando. “The community has difficulty staffing the two children’s hospitals that do exist. To try and add a third children’s hospital and duplicate services makes the care fractured and unsafe for children.”

Now an independent contractor for Orlando Regional, Cotter feels she’s able to serve the community better than when she was with Nemours. Cotter said in her experience, Nemours has a very inefficient system that discourages innovation.
Nemours does not provide any more innovative care than any other provider, said Dr. Matt Seibel, a pediatric hospitalist, who left Nemours in September 2006 after more than a decade with the company. Though nobody forced him, Seibel said he felt compelled to leave Nemours to stay on good standing with Orlando Regional.

“Competition is sometimes good for certain things,” he noted. “But when it comes to scarce resources, competition is not so good. If these two huge organizations ever cooperatively work together, the real benefit would be the children of central Florida.”



February 2008

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