Your Feb. 5 editorial discussed the tax measure proposed to rescue Doctors Medical Center in San Pablo. This hospital plays a critical role in saving lives, and we believe this editorial significantly understated the potential impact of its closure on patients and the health care system in the West Contra Costa County area.

The editorial stated that without the emergency room, "residents will be forced to drive farther when they need lifesaving help," but additionally said that "most of the hospital's services can be provided elsewhere."

This is an oversimplification of a complex issue -- the closure would mean much more than this.

Losing Doctors Medical Center would mean more patients would be sent to other already-overloaded emergency departments throughout our county and other counties, more stress would be placed on the emergency ambulance system, and, most important, care could be delayed in critical emergencies for people needing immediate and often specialized interventions.

Doctors Medical Center is more than an emergency department. It is the lone provider of advanced cardiac care for heart attack victims in western Contra Costa. Minutes do count -- timely interventions in heart attack, stroke and numerous other types of serious illnesses will be delayed, with the potential result of lost lives or increased disability when one of those illnesses strikes.

Compounding this is that the West County community as a whole is at higher risk than many for heart attack and stroke.

Access to emergency care in California is already highly compromised -- a recent report ranked California 42nd in the nation in that regard.

The East Bay is one of those areas already struggling to provide access, and that will worsen markedly if Doctors Medical Center closes.

Moving 35,000 or more annual visits to other emergency departments is much more than an inconvenience -- it will impact the timeliness of care for all patients in all those departments.

Last year, ambulances from Contra Costa's 911 system transported more than 8,000 patients to Doctors San Pablo. If Doctors' emergency department is closed, 911 will still be called and ambulances will still take patients to emergency departments.

But those emergency departments will be several miles farther away, and that means it will take longer to get people the lifesaving care they need.

While paramedics can provide some critical interventions en route, other patients require definitive care available only at hospitals.

It's clear that all of those ambulances cannot simply go to Kaiser Richmond, the lone remaining emergency department in the West County area.

Kaiser's emergency department is already very busy, is half the size of Doctors' emergency facility, and already receives more than 5,000 patients by ambulance annually from the 911 system.

Once an ambulance has left the West County region, local ambulance supply is diminished until that ambulance returns or another is moved there to replace it.

The problem is further exacerbated by delays for ambulances at hospitals when emergency rooms are bursting at the seams -- full beds mean that transfer of the patient from the ambulance gurney to the emergency department bed will be delayed.

Ambulances are scarce resources, and the response system has the potential to be significantly strained by the closure.

The impacts of the closure of Doctors Medical Center San Pablo won't simply be measured in time, gasoline, or wear on tires.

It will challenge provision of emergency medical services and the ability of surviving hospitals to care for all patients, and will be measured in lives lost or impaired.

Joseph Barger, MD, is medical director of Contra Costa Emergency Medical Services. Patricia Frost, RN, is director of Contra Costa Emergency Medical Services.