Los Angeles County supervisors still refuse to release details about 17 employees who worked at Martin Luther King Jr.-Harbor Hospital despite having serious criminal histories or lying about their records. After 16 of the workers were suspended, Supervisor Yvonne B. Burke said one of the employees had been convicted of rape. But neither the supervisors nor county health officials would address questions that might indicate whether patients were injured or placed at risk by the employees. Most of the public hospital closed after federal regulators determined that it did not meet minimum standards for patient care, but some outpatient clinic services continue. More than 700 employees remain at the site.
The University of Connecticut Health Center has issued a four-page invitation to hospitals across the state, hoping at least one will step up and help pull the center out of its financial malaise. Without regional cooperation, the institution that includes the Connecticut's medical and dental schools, a multimillion-dollar research laboratory, and the John Dempsey Hospital will have to continue seeking millions in aid annually from taxpayers. UConn President Michael J. Hogan hopes at least one hospital will be willing to foot part of the bill for operations and to help rebuild the aging Dempsey Hospital on the Health Center's Farmington campus.
Following a groundbreaking advisory on the potential risks of cell phone use, the director of the University of Pittsburgh Cancer Institute and UPMC Cancer Centers plans to develop a research project focusing on long-term cell phone users. Ronald Herberman, MD, hopes to obtain cell phone records from companies or customers to try to better identify long-term users who might especially be at risk for health problems. Herberman is holding discussions with others about the project, including a researcher at the M.D. Anderson Cancer Center in Houston, and doctors at the Pitt cancer institute's Center for Environmental Oncology.
One key component of physician satisfaction is how responsive hospital administrators are to physicians' ideas and needs. Rural hospitals tend to excel in this aspect of physician relations, which is probably one of the main reasons why doctors in rural areas had the highest satisfaction rates when compared to physicians in other regions, according to Press Ganey Association's 2008 Hospital Check-Up Report: Physician Perspectives on American Hospitals.
Even though rural areas can claim the most satisfied docs compared to other locales, rural America still probably has the most difficulty recruiting physicians and keeping them past the three- to five-year commitment often required by the J1-Visa program or student-loan reimbursement programs. Today's physicians not only want a responsive administration and ease in delivering high-quality care, but they also want state-of-the-art facilities, limited on-call time, and access to the arts and sporting events (without an hour drive), among other items. With physician shortages plaguing the nation, doctors can pretty much choose where they want to go—and unless they were raised in a small town, many aren't choosing America's heartland.
Exposing first- and second-year medical school students to rural medicine is one of the ways the healthcare industry is trying to increase the number of physicians choosing to practice in a rural area. I come across an increasing number of mentoring programs that link med students to rural docs or medical schools adding rural hospitals to students' clinical rotations. Some states have programs that highlight the professional careers offered in small towns in the hopes that more young people will choose to work where they grew up. For instance, Virginia has the “Return to Roots” program, which lists job openings—including healthcare positions—on its Web site. Postcards promoting the Web site are mailed to high school and college graduates from the area.
Sixty-three percent of physician recruiters say they are working more with resident and fellowship programs and shifting more of their emphasis to online venues, according to a survey of physician recruiters by LocumTenens.com this past spring. (Thirty percent of the recruiters surveyed represented rural areas with populations less than 50,000, and 44% percent came from small cities or suburban areas with populations between 50,000 and 250,000.) The survey also noted that physician recruiters were hiring additional in-house staff—83% of respondents were employed by hospitals or health systems. That's not always an option, however, for many cash-strapped rural facilities.
Still, rural administrators may want to expand their budget for conferences and other networking events. These events—often located at pricey hotels—are not always viewed as the best use of a rural hospital's resources. But physician recruiters ranked networking as the second most effective tool to recruit docs, according to the survey. The most effective physician recruitment tools were:
40% - online physician job boards
20% - networking
19% - physician recruiting agency
7% - broadcast e-mail
6% - journal advertising
5% - direct mail
3% - telemarketing
1% - journal or newspaper articles
I often hear rural leaders wishing that they had more opportunities to network with their peers and share best practices. Now, I can't tell you what events you should or shouldn't be attending. But if the event can help you fill a physician vacancy, I'd say it would be well worth the investment.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.
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Not long ago, employers tackled bulging health costs one way—by shifting more costs onto employees.
There is still plenty of cost shifting taking place in employee health insurance, but businesses are turning to health and wellness programs as a way to both reduce healthcare costs and improve employee health. A report released last week is giving employers some pointers as to how to create programs that engage workers. (Hint: there's more to employee engagement than placing health-themed posters on the bulletin board.)
Harvard Medical School's Department of Health Care Policy conducted the review of BlueCross BlueShield Association's Engaging Consumers@Work program, a workplace initiative that includes physical activity, workplace wellness programs, and nutritional behavior. The 10-week pilot split participants into two groups: education and education plus activation. Some of those activation activities included guides and tracking logs, online signup and tracking capability, pedometers, and employer internal worksite competitions.
The report found workplace education and activation programs increased worker participation in wellness programs by at least 21%.
The report's key findings included:
Education combined with an activation program is more effective than education alone
Knowledge and awareness of health-related information improved post-intervention
Employees are more likely to remember in-home communication than worksite materials
What can employers and health plans learn from this report?
Incorporate activation components into health and wellness programming to drive greater employee engagement. Examples of these kinds of components are healthy eating/weight loss programs, smoking cessation programs, and activity-based stress-reduction programs.
Expand educational health-related messaging. These kinds of messages can be delivered at a low cost, such as stapling information to employee checks or adding health facts to employee newsletters.
Internal promotion and communication of worksite programs is critical to increase participation and ensure program success. Employers must continually educate their employees about worksite health programs. This goes beyond placing a poster on the wall. The study found that people remember direct mail messages sent to the home rather than worksite communication.
Helen Darling, president of the National Business Group on Health, a nonprofit organization of employers based in Washington, DC, said employers have moved past strictly looking at cost and benefit design as a way to reduce costs.
"We have seen a sea change about how employers think about health benefits, healthcare, and the health and productivity of their employees and their dependents," said Darling, who spoke at a press conference last week announcing the report.
Employers have a major role in improving employee health. The Henry J. Kaiser Family Foundation Kaiser Health Tracking Poll: Election 2008, released in June, showed that employees view employers as critical components to their healthcare. They expect their employer to be an active participant in looking out for their best health interests. An overwhelming majority of respondents said their employers lessen their burden of finding affordable, high-quality health insurance and help them with administrative duties. Mary Nell Lehnhard, senior vice president in the Office of Policy and Representation at the BlueCross BlueShield Association in Washington, DC, says employers don't have many options when it comes to lowering costs.
"As a big employer, you can change the delivery system, which is impossible, or you can lower the costs of your own employees by keeping them healthy," says Lehnhard. Richard Lueders, director of human resources at DTE Energy, a southeastern-Michigan-based energy provider with 10,000 full-time employees, said at last week's press conference that employers now understand that prevention is the way to go.
"At the end of the day, prevention is far less expensive and far more beneficial to everyone than the cure," said Lueders, adding that keeping employees healthy is a "win-win."
It can be a win-win, but employers must keep a long-range vision. Improving employee health goes beyond an immediate positive return on investment and may take years to see savings. Taking a broader view on healthcare is quite a change for employers, but businesses are finding simply passing more healthcare costs onto employees isn't working. Health management programs could be a solution.
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com .
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This week marks the one-year anniversary of the HealthLeaders Media Marketing Weekly e-newsletter and this weekly column on healthcare marketing. And what a fun year it's been—I learn something new every week, often from the generous readers who write to me, sharing their opinions and expertise. A lot has happened during the past year, so I thought I'd update you on some of the topics and stories I've covered (including new developments on two of the most controversial columns I've written).
New media and the modern marketer
Every once in a while I express some healthy skepticism about the latest new media marketing techniques. It's not that I don't believe in the power of new media—I do. It's just that I don't think every form of it is going to work in the healthcare industry [Virtual Reality Check, November 14, 2007].
But that doesn't mean that all healthcare marketers agree.
In an online HealthLeaders Media poll, we asked respondents "How do you view/use new media in your marketing? Most (42%) said it is "vital" and said they were looking to expand its use. Another 26% said it is "somewhat valuable." Another chunk of respondents (31%) said they're not sure if it's effective. And 1% said they don't see any value in it and that it is a passing trend that's not worth investing in.
It seems as though 99% of us are still trying to figure this one out. Frankly, I'm not sure what's going on with the other 1%.
Most of the responses were from marketers who are frustrated with physicians because they don't seem to understand that their behavior affects patient satisfaction, the hospital's image, and, ultimately, the bottom line.
One reader noted that this is not just a marketing problem. She pointed to the recent safety alert issued by the Joint Commission about the dangers of bully doctors. Bullying doctors can make nurses afraid to question their performance, according to the alert, resulting in medical errors.
We did a HealthLeaders Media online poll on this topic, too.
We asked readers what they think of mystery shoppers. Most (nearly 70%) said they are "a good tool to improve quality and patient satisfaction." Only 15% said they are a "poor indicator of quality and patient satisfaction."
Time is money, but not for the CMO
In May, I wrote about reports that the average tenure of chief marketing officers is shorter than that of the CEO [Is Your Boss Advertising For Your Job? May 21, 2008]. Since then, more evidence has surfaced that chief marketing officers are the assistant coaches of the C-suite: first to get blamed for a loss, last to get credit for a win.
Among the 100 companies in a recent AdAge review, 28 fired or lost their top marketer in 2007 or 2008.
But wait, there's more. The average CMO-level executive last year took home $1.5 million, according to AdAge. "Nice pay," the magazine writes, "but nothing next to the $15.5 million hauled in by Dell Chief Marketing Officer Mark Jarvis."
Ouch.
Beware of pharma reps bearing gifts
Finally, one of the most controversial topics in this space over the past 12 months was the practice of drug company reps showering docs with knick-knacks. [Drug Logo Overdose, January 23, 2008].
So many readers responded—some agreeing with my opinion and some decidedly not—that I wrote another column the following week in order to air some of the different viewpoints [Saints, Sinners, and Bringers of Dinner, January 30, 2008].
The latest news on that front: The pharma industry's biggest U.S. trade group announced this month a moratorium on such gifts. It's a move they've long promised, but don't get too excited: The guidelines are voluntary.
It seems the more things changed in the past 12 months, the more they stayed the same.
Gienna Shaw is an editor with HealthLeaders magazine. She can be reached at gshaw@healthleadersmedia.com.
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