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The operating room will shut down at the Heidelberg Health Center on Sept. 1, the last major step in turning the hospital into a clinic, medical officials say.

Same-day surgeries such as arthroscopic knee and ankle procedures will no longer be performed at the center, said Col. Paula K. Underwood, the new medical commander.

"They will be seen by a physician here to determine if they need surgery," Underwood said. "And then one of two things will happen: they will be sent to Landstuhl or they will be seen on the local economy," in German hospitals.

Steve Davis, spokesman for Europe Regional Medical Command, said the center will continue to offer a few outpatient surgeries, such as colonoscopies or some orthopedic surgeries, along with acute care for non-life threatening illnesses and family practice services.

ERMC officials decided in January 2008 that given the shrinking number of personnel using the facility, the 63-bed hospital had become unaffordable. Since then, people have had to go to local German hospitals for emergency care and to give birth and undergo inpatient surgeries.

Underwood said the staff could be used better elsewhere and doctors were unable to give continuous care to the surgery patients because the hospital lacked certain facilities.

"Not having an inpatient facility kind of limits the extent of surgeries you can perform," she said. "If a person having a knee scope was to have some complications, then we would have to transfer that patient."

Underwood said that from Oct. 1, 2008, to March of this year, an average of fewer than three surgeries per day were conducted, she said.

"It’s just not a question of economics," she said, "but ensuring the spectrum of care to perform the procedure."

Underwood said she and her staff were working to ensure the transition goes as smoothly as possible, informing residents of the closure and reminding them to use the patient liaison service, which is designed to smooth their experience in German hospitals.

"We have been referring people to our host nation hospitals for decades," she said. "We have a long and prosperous relationship with our host nation hospitals."

Underwood did not foresee any layoffs at the clinic, but she said some people might have to be transferred to new positions.

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