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 Lowell Albert Wetter, MD for General Surgery Services
RECOMMENDATION:
title
Adopt a resolution authorizing an agreement with Lowell Albert Wetter, MD to provide general surgery services, for the term of January 1, 2026 through December 31, 2028, in an amount not to exceed $1,073,472.
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BACKGROUND:
General surgery physician coverage is required by the State of California to operate San Mateo Medical Center (SMMC) under “Title 22” general acute care hospital licensing requirements. See 22 Cal. Code Regs. § 70225 (“Surgical Services Staff”). Dr. Wetter will fill an expected gap in coverage when Palo Alto Medical Foundation ceases general surgery services at SMMC effective January 1, 2026.
DISCUSSION:
Dr. Wetter will provide up to 60 four-hour outpatient general surgery clinics to consult with patients before and after surgery, up to 60 four-hour operating room blocks to provide surgical services, and up to 60 days of 24-hour on-call shifts to respond to emergent patient issues. Dr. Wetter will be compensated at a rate of $409.00 per hour for clinical services and $54.00 per hour unrestricted for on-call coverage.
The 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.
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 85% of patients screened for positive tobacco use will receive cessation counseling.
PERFORMANCE MEASURE:
|
Measure |
FY 2025-26 Estimated |
FY 2025-26 Projected |
|
Percentage of patients screened for positive tobacco use will receive cessation counseling |
85% |
85% |
COMMUNITY IMPACT:
Dr. Wetter’s general surgery coverage will positively impact health outcomes because the delivery of general surgery services at SMMC, a public safety net hospital, addresses a critical community need and is legally required by the State of California to maintain SMMC’s general acute care hospital license. SMMC’s patients represent a wide spectrum of races, ethnicities, genders, and gender identities. Over 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%). To promote quality and accountability, SMMC provides training to physicians and follows up with patients to ensure continued access to specialized care. In addition, SMMC tracks physician satisfaction survey results and requires Dr. Wetter to meet with SMMC leadership to review patient feedback, strengthen patient satisfaction, and address potential barriers to care.
FISCAL IMPACT:
The term of the agreement is January 1, 2026 through December 31, 2028. The amount of the agreement is not to exceed $1,073,472 for the three-year term. Funds in the amount of $357,824 are included in the SMMC FY 2025-26 Adopted Budget. Funds in the amount of $357,824 are included in the SMMC FY 2026-27 Recommended Budget.
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.