With 663,000 more jobs disappearing from the American economy in March, the government's response to the downturn is being put to a strenuous test. Three months into the year, the unemployment rate has already soared to 8.5%, from 7.6%, the highest level in more than a quarter-century. The severity and breadth of the job losses in March prompted economists to conclude that an agonizing plunge in employment prospects was still unfolding.
The Obama administration's plan to spend $19 billion to hasten the adoption of electronic health records that can share data across networks will only give more impetus to the shift toward Internet-style computing. One good example of the trend is a joint project, between the Centers for Disease Control and Prevention and GE Healthcare. The project will deliver individually tailored public health alerts to electronic health records in doctors' offices. The goal, for example, is to have an alert pop up on a physician's screen that a certain patient, based on location, age, and perhaps occupation, might be at risk for an influenza outbreak that is nearing a certain community or for contracting a food-borne illness.
There is a common misconception among hospital administrators that burn centers are neither self-sustaining nor profitable. However, this is a world view at odds with my personal experience. If managed properly, plastic surgery-based burn centers can be new, highly profitable revenue sources that bring enhanced prestige to the hospitals with which they affiliate.
Hospital administrators and executives are often skeptical about the cost and sustainability of burn centers, and question how burn care will fit into the overall business structure of the organization. This hesitation to embrace burn care as a business solution rather than a cost center likely stems from a limited perspective on the true nature of burn care and an underestimation of the size and scope of the market.
True "burn care" is more than just the acute care and stabilization rendered by a general surgeon prior to transferring a patient to another facility for follow-up care. It constitutes a full range of services—from acute care and reconstruction to rehabilitation and psychological counseling. Fewer than 30% of the burn centers in this country are plastic surgery-based, even though this model has been proven effective. For example, the Grossman Burn Center in California has plastic and reconstructive surgeons, intensivists, internists, pediatricians, and a full range of service providers including dieticians, therapists, and counselors who treat the patient functionally, emotionally, and cosmetically.
Hospital administrators also need a better understanding of the "market" for burn care. While natural disasters and house fires make headlines, occupational burns are far more common and a perennial risk in just about every community. Auto mechanics, electricians, industrial plant workers, and machinists are among the professions that are at risk of burn injury. Additionally, almost one-third of the patients we see in our practice are children.
This underestimation of the demand for dedicated burn centers, coupled with misconceptions about their viability, has led to a severe lack of burn care resources throughout the country. Taking a regional approach to establishing new centers to treat underserved populations is one way the healthcare industry can address this shortage. Targeted population centers with easy access to interstate highways that serve rural and outlying areas, and that are in close proximity to high risk populations such as heavy industry and fire zones, are ideal places for hospitals to expand services and locate a dedicated burn center.
Establishing a burn center in an existing hospital is not the daunting proposition that many hospital executives perceive it to be, either—especially if they have the right partner. For little up-front investment, a hospital can covert existing ICU beds into a dedicated burn-care ward, without incurring the costs of a major build-out. A four- to eight-bed unit requires about 3,000 square feet, a continuous block of operating room time, and the right professional partner to recruit, train, and manage the on-site personnel.
Once up and running, better carve-out rates for burn care can usually be negotiated with insurers, as well. For instance, a dedicated burn center can yield as much as 200% of Medicare costs. Further, by capturing the full range of services required to affect a significant functional and cosmetic recovery, burn centers are actually accretive to revenues, not the cost center many providers perceive them to be.
With the healthcare conversation today being dominated by proposed public policy reforms that are aimed at improving the patient's access to care from an economic standpoint, we run the risk of paying too little attention to the need for better and greater numbers of healthcare delivery assets. The more the myths about the business of burn care and the markets served by burn centers are debunked, the greater the opportunities for providers will be.
Peter H. Grossman, MD, is a Board-certified plastic surgeon and president of Grossman Burn Centers. For more information, visitThe Grossman Burn Center.For information on how you can contribute to HealthLeaders Media online, please read our Editorial Guidelines.
Increasing market share in today's environment is not easy, as patient volumes are down and people are postponing elective surgeries and cutting back on doc visits. Sg2 analysists suggest capturing new market share to recoup any that has been lost. They also say it's important to go into the market aggressively and capture the volumes that still exist, and establish benchmark metrics that go beyond market share and regularly evaluate progress.
Healthcare leadership is dominated by men. All one has to do is attend a healthcare leadership conference and glance around the room. The majority of attendees will be older white males (with the exception of a nursing or quality leadership conference).
Seventy-two percent of healthcare CEOs are male, according to the HealthLeaders Media Industry Survey 2009. While the industry is making strides in leadership gender diversity, there is still a lot of room for improvement. And the sooner this occurs the better it may be for hospitals' bottom line.
Generating the best and most innovative ideas requires teams that are comprised of equal numbers of men and women, according to research out of the United Kingdom. In addition, companies with at least 25% of executive positions held by women yield a 35% higher return on equity than companies with fewer women in top positions.
Based on this type of information, Norway's minister for trade and industry, Ansgar Gabrielsen, declared last year that 40% of all boardroom positions in companies listed on the Oslo stock exchange needed be held by women within five years. If companies did not comply, they would be prosecuted. That was a pretty bold move considering that 94% of all board positions at the time were held by men, according to this Fast Companyblog analyzing Norway's leadership strategy.
I'm not suggesting that healthcare organizations should mandate the number of executive leadership positions held by women. But I think its worth noting that having a more equal distribution of males and females on the team could yield better operational results. People are more likely to contribute thoughts and ideas to a discussion if they are not in the minority. Sure there are strong personality types that break this rule but, in general, people are less likely to speak up if they are the only physician, or patient, or female in the room.
I'm curious to know what you think, "Do healthcare organizations have enough female representation in the senior executive suites?"
Oh, and if you think your leadership team is at the top of its class, you still have time to enter the HealthLeaders Media Top Leadership Teams in Healthcare contest. Now in its fifth year, the program recognizes the best in senior leadership teamwork at hospitals, health plans, and medical group practices. This year's winners will be honored during HealthLeaders Media '09: The Hospital of the Future Now, an event planned for October 15-16 at The Palmer House in Chicago. Go to the Top Leadership Teams site to learn more about the six categories, download an entry form, and submit your entry. The deadline to submit is April 30.
Carrie Vaughan is leadership editor with HealthLeaders magazine. She can be reached at cvaughan@healthleadersmedia.com.
Note: You can sign up to receive HealthLeaders Media Corner Office, a free weekly e-newsletter that reports on key management trends and strategies that affect healthcare CEOs and senior leaders.
Gov. Kathleen Sebelius of Kansas appeared to be headed for confirmation as health and human services secretary, but several Republican senators objected to an immediate vote, so the Senate is unlikely to take up the nomination until later this month. Sebelius sailed through a hearing of the Senate Finance Committee without encountering any difficult questions about her income taxes or her views on abortion. But Republicans later asked that the committee defer action.