ROCK SPRINGS - City residents generally supported the planned renovation of Sweetwater County Memorial Hospital during a meeting Wednesday night, but many wondered if there will be enough doctors and specialists to fill the new spaces.

Others among the 40 or so who attended the meeting wanted reassurances that the hospital will be able to pay the mortgage for the proposed renovation project that could cost as much as $28 million to complete.

Hospital administrators said they were confident doctors will come and that the expansion can be fully funded with little impact to local communities.

Hospital officials say it's time for a major renovation of their 25-year-old facility that was designed and constructed in 1978 primarily for inpatient care.

Demands for new diagnostic and treatment processes, for new outpatient services, escalating medical costs and new federal and regulatory mandates make it imperative that the hospital consider changes to health care services and facilities, officials said.

Major changes are planned under the expansion for the emergency room facilities, for the clinical lab, for labor and delivery areas and for same-day surgery, according to plans.

During the first of two public meetings on the expansion plans held Wednesday night in Rock Springs, county residents were supportive of the renovation proposal, but some worried that the hospital may not be able to recruit enough doctors to fill the needs of the expansion.

Recruiting general practitioners, especially specialists, has been difficult in recent years, residents said.

"The need is not disputed if it makes it [a] better [facility] … but how are you going to staff it? Where are these doctors and nurses going to come from with the expansion?" asked Jeannine Cox, executive director of the Young At Heart Senior Center in Rock Springs.

Cox said the center conducted a recent survey of its seniors, and the top three topics listed in importance was "more doctors, more specialty doctors and the expansion of emergency rooms."

Most seniors, she said, "are in favor of something being done … and remember they utilize that facility more than most … but they wonder where that staff is going to come from."

Hospital physicians agree "the renovation has to happen … we do want to go to a more user-friendly outpatient facility if we can," said Dr. Lo-Fu Tan, the hospital's chief of staff.

"We're also concerned about recruitment as well," he said. "The dream is to have more specialists and physicians … and a really nice, modern facility will allow us to do more with recruitment, if we have that opportunity."

Hospital board chairman Larry Caller agreed it was difficult to recruit specialists and said what's needed most is a large group of primary care physicians in the area that can refer patients to specialists.

"From my perspective, it has been difficult to recruit … but what we can do to bring people here is to offer a newly remodeled, modern facility," Caller said. "This expansion will go some distance toward helping with physician recruitment."

Under the hospital's finance plan for the expansion, a newly-formed Joint Powers Hospital Board will seek financing from the sale of revenue bonds that are secured through a U.S. Department of Housing and Urban Development (HUD) loan.

Rock Springs resident Andrew Fech worried the project costs could financially impact local communities down the line if the hospital can't make the mortgage payment.

"My problem is I don't see where you will generate that much more revenue," he said.

"Hospital rates are about as high as they can go with insurance … with this kind of expansion, is there a chance you can't make that kind of payment?" Fech asked. "Is it safe to say you're 90 percent sure this won't hurt communities by doing this?"

"Absolutely yes," hospital executive director John Ferry replied.

Tan said the county's residents will have to support the facility if the expansion is going to be financially viable.

"If you're worrying about how to pay for this … think about getting surgery and care in your local hospital," he said. "The physicians here are extremely skilled and want to be here. They're part and parcel of making all of this work. It's got to be a joint effort."

Dentist Grant Christensen applauded the board for seeking HUD funds rather than a bond issue to finance the planned expansion.

"I think you're wise in pursing the funding you're pursuing, but make sure you've got enough money to pay for it," he said.

"The wish list always gets bigger, and the reality of what you can build gets smaller," he cautioned. "Think big, but county your dollars before getting started."