Tenet Southern States Region has named Janie Sinacore-Jaberg CEO of East Cooper Regional Medical Center, a 100-bed acute care facility located in Mount Pleasant, SC, effective Oct. 15.
Vincent L. Johnson Jr., vice president of administration at Shands Jacksonville Medical Center in Florida, has been named COO of UC Davis Medical Center, effective Oct. 27.
An alarming report from the Associated Press claims that the nation's hospitals flush about 250 million pounds of drugs down the drain each year, potentially contaminating the water supply.
Lost amid the collapse of the stock market, the bickering presidential campaigns, the Hurricane Ike cleanup and the mayhem and violence overseas was the passage last week of a major civil rights bill for Americans with disabilities. The White House said President Bush would sign the bill, just as his father signed the original Americans With Disabilities Act in 1990.
Hospitals across the nation are working toward greater efficiencies, using strategies like lean manufacturing and Six Sigma to reduce waste and costs while improving patient outcomes.
The Wall Street Journal (subscription required) is reporting that Americans are already cutting back on healthcare, a sector once thought to be invulnerable to recession. Spending on everything from doctors' appointments to preventive tests to prescription drugs is under pressure.
Clarian Health in Fishers, IN, said last week that pending a few more town council votes, its $180 million hospital construction project should be open to the public by the fall of 2010. The project also includes future plans to develop a $750 million medical campus nearby.
According to prosecutors, Staten Island University Hospital fraudulently received tens of millions of dollars from government health insurance programs between 1994 to 2005. Now, the hospital has agreed to pay back the $88.9 million. The money had covered various hospital services, including substance abuse detoxification, inpatient psychiatric care, cancer treatment, and residents' training.
"If you build it, they will come." That immortal line from the novel and movie "Field of Dreams" applies to baseball ghosts and Iowa cornfields, not necessarily to hospitals.
A recent story in the L.A. Times should send a shudder down the spine of any healthcare human resources professional already feeling the effects of the nation's physician and nurse staffing crunch.
The University of Southern California School of Medicine has raised concerns that a brand new county hospital set to open on Oct. 17 won't have enough staff to handle the caseload. In a letter to Los Angeles County officials, USC Med School Dean Carmen A. Puliafito, MD, warned of "an impending patient safety crisis" at the 600-bed County-USC Medical Center, which Puliafito says "will not be able to operate safely with the current staffing available," the Times reports.
In his letter Puliafito noted that nine emergency department physicians at the existing and soon-to-close County-USC hospital have left since January for better-paying jobs, along with eight nurse practitioners and physicians assistants, none of whom have been replaced.
LA County CEO William T. Fujioka assured the Times that the issue is being addressed. "There will be no jeopardy whatsoever to our patient-care programs. We're going to work with them toward filling the positions," he said.
I want to believe Mr. Fujioka. I'm sure he is an honorable man. But I really wonder if he's checked the market lately for emergency department physicians and support staff, especially for a lower-paying, safety net hospital with a high caseload of indigents and uninsured.
The new County-USC is built for 137 emergency department beds, but only 87 will be staffed. That won't help waiting times and certainly indicates that staffing will be an issue, despite the county's best assurances.
Remember, one out of three practicing physicians in the United States is more than 55 years old, and they're expecting to retire within the next 10 to 15 years. The nation's medical schools will have to beef up enrollment by about 17% by 2012. It'll help, but it's not enough to cover the potential loss of one-third of the physician work force. Depending on who's doing the estimating, the United States will be short anywhere from 24,000 to 200,000 physicians by 2020.
Relax, we're told. We'll just have to rely more upon "physician extenders" like nurse practitioners and physicians' assistants to carry more of the load. The people who tell us that clearly haven't tried to recruit nurses lately.
Be prepared to read a lot more stories about physician and nursing staff shortages in the coming months and years, as the full effect of the healthcare staffing crisis makes itself known to the general public.
John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.
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I had a great column set to go this week. It was written in advance. That was good for me, since I was at a conference for the first half of the week, and planned to be out of the office for the second half. But when I got back from the conference, I just had to put that column on hold.
Because events intervened.
Specifically, the events that intervened involved a further meltdown of our financial system. The Healthcare Deal Making Summit here in Nashville has always been a well-attended conference, with lots of power suits in attendance from investment banks, private equity funds, and organizations seeking money from those investment banks and private equity funds to build their healthcare businesses. Most years, as we say in this part of the country, you can't stir them with a stick.
But this year's event was eerie. By lunchtime on the first day, it was clear from the large number of name tags that hadn't yet found their owners that a lot of people were dealing with bigger problems than the next imaging center company to acquire or finding funding for the next big idea in healthcare IT.
One of the panelists in the first session I attended was from Merrill, where he's worked for more than a decade and has been involved in more than $80 billion in healthcare financings. With gallows humor, he told the audience that as of Jan. 31, Bank of America would be his employer, or so he hoped.
That something strange was going on was easy to see as I exited the session. Dozens of people were on their cell phones in the hallway talking in hushed tones. Panelists were fiddling with their BlackBerrys up to the moment the moderator kicked off the discussion. Nowadays, it's not unusual to see people bowing out of sessions at a conference to take or make phone calls, but at times it seemed as though those in the hallways outnumbered those in the sessions. And the hallway people multiplied after lunch.
Speaking of lunch, by my count, about 50 or so plated lunches went uneaten. As the markets continued to bleed, attendance at the sessions got more and more sparse.
The next day, Wednesday, was even worse. At the last session on distressed investment strategies—normally a very well-attended session—the irony was palpable as only 25 or so people listened to the five panelists on stage describe the typical financial problems healthcare companies and nonprofit organizations run into and how to tell whether a turnaround is possible. They could've just as easily been talking about the organizations that many of the attendees work for. And the hallways that the day before contained dozens of cell-phone toting power suits were nearly empty. I was witnessing a microcosm of what happens when the music stops playing in the musical chairs game of easy money run amok.
As I write this, the Dow Jones Industrial Average is down more than 500 points. That's just today's damage during this particularly vicious cycle. In the past four days, a large investment bank declared bankruptcy (Lehman Brothers) and another was taken under by Bank of America before the same thing could happen. The common stock of the last two independents, Goldman Sachs and Morgan Stanley, are hurting badly despite the fact that both made profits last quarter. Yesterday, the federal government essentially took over the giant insurer AIG, not because its core insurance business is bad, but because it leveraged that business to take on more risk and is now reaping the whirlwind, as many others have done over the past several months of pain on Wall Street.
So what does this have to do with healthcare finance? It's a trickle-down effect. Borrowing's going to be more difficult and leverage is now a four-letter word. Certainly my little experience doesn't spell the end of the world as we know it. Hospitals will still be able to borrow, good ideas will still get funding.
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