Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Colleen Chawla, Chief, San Mateo County Health
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Vijay Pottathil, MD, to Provide Gastroenterology Services
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Vijay Pottathil, MD, to provide gastroenterology services, for the term of February 1, 2026 through January 31, 2029, in an amount not to exceed $2,528,280.
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BACKGROUND:
San Mateo Medical Center (SMMC) has contracted with Dr. Pottathil since 2019. Dr. Pottathil expanded his work at SMMC where he provides in-clinic, inpatient, medical director leadership, and on-call coverage. The proposed renewal would continue Dr. Pottathil’s clinical gastroenterology (GI) coverage and medical director services at SMMC.
DISCUSSION:
Dr. Pottathil’s previous contract obligated him to provide up to 432 four-hour blocks of outpatient GI coverage inclusive of endoscopy, up to 48 four-hour blocks of supplemental clinical services, up to 4044 hours of annual unrestricted on-call coverage to respond to urgent and emergent GI patient care issues, and up to 10 hours per month for medical director services at SMMC in his specialty. The proposed agreement continues this same quantity of clinical coverage and his medical leadership services without change.
The County Attorney has reviewed and approved the resolution and agreement as to form.
The resolution contains the County’s standard provisions allowing amendment of the County fiscal obligations by a maximum of $25,000 (in aggregate).
It is anticipated that 99.7% of endoscopy complication cases will not lead to a repeat procedure within 30 days.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2026-27 Projected |
|
Percentage of endoscopy complication cases that will not lead to a repeat procedure within 30 days |
99.7% |
99.7% |
COMMUNITY IMPACT:
Dr. Pottathil’s continued GI coverage will positively impact health outcomes because delivery of GI services at SMMC, a public safety net hospital, addresses community need. SMMC’s patients span a wide spectrum of races, ethnicities, gender, and gender-identities. Within the past 18 months the largest cohorts of specialty care patients at SMMC were female (52%), Hispanic or Latino (63%), and primarily Spanish speaking (55%). SMMC strives to eliminate bias in the medical profession by providing training to its physicians and by following up with patients to ensure that they continue to have access to specialized care. SMMC specifically tracks physician satisfaction survey results and requires Dr. Pottathil to meet with SMMC and discuss patient feedback to improve patient satisfaction and remove potential barriers to care.
FISCAL IMPACT:
The term of the agreement is February 1, 2026 through January 31, 2029. The amount of the agreement is not to exceed $2,528,280 for the three-year term. Funds in the amount of $351,150 are included in the SMMC FY 2025-26 Approved Budget. Funds in the amount of $842,760 are included in the SMMC FY 2026-27 Recommended Budget. Similar arrangements will be made for future years.
The cost of the proposed agreement will increase by nine percent (9%) compared to the prior agreement. Although incremental on-call compensation rates decreased, arm’s length negotiation increases in the hourly clinical services rate and medical directorship compensation rate resulted in an overall increase in contract cost. The increased rates in the new contract are within fair market value, according to VMG Health, a nationally recognized medical services valuation firm that relies upon multiple industry-standard provider compensation surveys and aggregates that data.
Expenses at SMMC are covered by fees for services or third-party payors whenever possible. The portion of expenses for services provided to the medically indigent or to those covered by programs that do not meet the full costs of care is covered by the County’s General Fund contribution to SMMC and is within the existing annual appropriation.