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Think Tank 1210pm Hospital Funding

Jun 2, 2016|

Did you know that cutting hospital funding could jeopardize doctor-training programs in our medical schools, too? Cuts to hospitals may be part of Louisiana’s answer to closing our monster deficit. But what if we lose our best doctors in the process? Can Louisiana afford to lose doctors who might have to do training elsewhere? This hours guest: Dr. Peter DeBlieux - Chief Medical Officer of University Medical Center New Orleans, home of the Reverend Avery C. Alexander Academic Research Hospital Dr. Jeffrey Wiese - Associate Dean of Graduate Medical Education at Tulane and head of the internal medicine residency program

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Automatically Generated Transcript (may not be 100% accurate)

Valued there is one facet of this problem that I better than ever thought about. Seemed like it was jungle legislature. From Edwin Edwards all on done they meet. All we're ending trouble we're gonna cut everything in sight but in particular or higher education. And health. Hospitals. Health benefits to people you're there and it's always. Always there. I've thought about what had marched doom. Two young doctor that the group who threes seven years. Of training. Yeah as saying he'd where they're constantly being tall and their profession. Mean it will be funded or make a big combat troops and shall. I read this see you know open area hospital in Baton Rouge that quote blows. I think legislative body doesn't have the appreciation. I'll poke holes will resort to totally. Dismantling. Of the educational program. Or future of positions. Amanda Beard exaggeration but it certainly brings up Arabia situation. Have not Barbara then. What's our broad number of things I do bonds soared take a look Gibbons says it's it would go talk to doctors. But no what's the word should is thankfully. We're sailing some time from doctor. Peter W bug chief medical lobster university medical center of New Orleans. Doctor thank you blew the time. So Bill Clinton have been doing it today. So VOC year old that I just quote. Legislative body doesn't understand. How close were getting to that total dismantling. Of the educational programs of puede troop positions. Exaggeration. If so what is the search wars. So dire situation. And that it will. Charity hospital. For thirty years and so on now outstanding and university now that are. Which is the next generation of charity hospital the reverend. Alexander. Academic and research hospital. And that loses. This is the next generation of health care for all our patient but what may the next generation is. The continued mission to raise the net. Generation. Of health care providers. Not just positions but also numbers. Allied help personnel also physical therapists occupational therapist. Radiology technicians lab technicians the people. Take care of food and next fifty years or within these walls today. So those those students those positions being foreign. Did they not have an option to Gordon other's needs to go to other programs is it. So different called term to become a doctor together in med school in and get into. Training. That they have no other option. Know they have some other options we're doing our that. To recruit and retain the State's brightest individuals. To contribute to our community and help our future. On community. Well it is tough it's tough particularly win you know just like clockwork we can you know kind of got to die each year. To have front of the things that are going to be cut ours and what's going to be Kotler unprotected. Health and hospitals and higher education. And what many you may not appreciate. Is you're cutting. You user due. To higher education have those health care providers that are participating in higher education. So you'll want to stop being cut as Oprah out there on aging and that. Cut at a hospital. Who's paying that professor Hage. So it actually collected in the. I had head of the Appropriations. Committee Helms on you know yesterday. He did and duty obviously he heads up the community that dictates the money. And I mentioned the 600 million dollar deficit he says from William is no. He said we have the money. To pave the budgets of hospitals moderate occasion. Where rumors claiming. That they're hurting for money we have BM government to pay dimmed their budgets over the last year. But we don't have the money to pay for. Blood more they want and they always want more. If your budget blues is same budget you have last year. Or all we still running threatened of losing young doctors. So garlic last year I was in a dilapidated hospitals that was devastated by Katrina. That did now bird. The appropriate care more patient population. Should. Yeah I have in to a one point two billion dollar quality that was designed. To create a living environment to the next generation of health care providers. The reverend. Alexander resurgent academic hospital university medical center accused now now that the larger footprint. It ought to have a lot more to power it. Let Timor to maintain it and work. That we've actually increase the number. In the and again an area. You know the tale that is. You know a tremendous need for our community. We're operating more cleaning services and we've ever offered both war and we've enhanced our access. Would not only added all of those pieces but the quality of care that we're delivering its higher. So we're seeing more patient. There's spending less time in the hospital and that I think improved access to our clinics. A whole each year. You higher educated from will be held will there be any number of big ticket items. We we get federal subsidies we give to federal branch is there. Or there doesn't federally allocated federally funded slots. Four of these doctors and we cut back on the money we're giving you. Do the Fed cut back on their money. The methodology. Here in where I think. Better and that 33%. 20% 15% range. If we're going to diminish our services we you don't care that we're offering to the community. It where did it reducing. Services. Also those contracts. To LSU and Tulane medical schools which in turn pay rapid. To be here because. Of reducing service so sub positions will be. That directly impact the number of patients that we. But more importantly. It. The number of providers who're trying to go out to the community to provide health care to our region. 70% of our graduate. Remain with Louisiana. To deliver health care with him Louisiana. They don't all stay at this hospital they go out to hospitals across the region so that is a singular. Hospital problem. Problem that will negatively impacted Al Avaya a higher state. He keeps heavenly percent. We've got to and I think UNC was one of them who got some very good private hospitals had taken over the management. That stole the save you keep talking about cutting margarine caught coming and where will get out of Brock contract from walked away. Heidi it keeps only percent to graduates. When they're constantly hearing about cutbacks and the people that run their hospital. Are talking about possibly walking away and I think board viewed told real wanna bread. Taxes Arkansas Mississippi Alabama Georgia none of them have had the continuing conflict the we have here in Louisiana. You know I'd be lying to you by that we don't lose some of our graduates from medical school to other states. I would tell you that LSU Shreveport and LSU and continue to offer the best value education from medical school anywhere else in the country. The problem is holding on to those that the brightest to do their residency in advance graduate medical education training. Here. Because we don't know that the majority of people in training. Within a residency program go want to practice within that community. Because that's where they established their ties. But work and it certainly. People to places like. Houston and Dallas Atlanta. Where again that the bride Serbian poll of those places it's easy being recruited to those places when there having to deal would cut. Every single year. Are limited breaker boomer come back on a more read to you. Statement by via secretary of Louisiana is the eight change. Of this secretaries said. If disable loses. Some of its 19100. Plug residency. Positions. We are glued lose compulsion the need to train doctors in this state. Doubled up. We're of all her veto threats. Coming up the legislature it seems like. Every time there will hold a session over the decade we got to cut were in deep trouble. And the ones that they usually get around cutting more higher education than hell hole. And it just seemed like common sense that you can only coats so much until. We soared and some major problem. And one of the problems and I it's certainly not considered in if you or a doctor and trying urine residency three to seven years. And you'd have to go to. A training facility. Do you come here worry it's constantly. Conversation it is cutting the budget cutting people caught in the hospital. Hospital administrators. Private entities talk a little while walking for management plots that'll. It would saying that sooner or later roommate being now we're getting into position. Where we could be losing doctors for generations. In this state and I don't think we can reported I was reading this excellent side it is. Good to us that. 81% real reason I'm. Is federally designated. As an all professional shortage area for primary. Care. Federal soon as we have doctor and pewter W group as chief medical Alter university. Medical sooner. Britain pulled we unit took a break. Quoted. The US secretary dear cheer each here in the weeks and she says it. If the state loses some of its 19100. Plus residents the positions. We permanently. Lose capacity. At Torrey doctors in this day what would she mean. Well what she means this winter weather pro program if we Cuba does training positions. Never to recruit them again our hospitals reverend Avery Gil Alexander hospital at UNC. Train over 900. Residents between LSU in two lane every single year that. In addition in addition we have well over 15100. Others students. Nursing student allied health care professionals that come through these doors. Sort of caught those. Means to lose those positions because we're not suddenly in the again private entities on those positions. To train future health care providers who noted that it. Garland added tack you in acts mean that there's out here or. Sixty years. As you are now accepting health care more frequently it impacting you. It's like to call at great risk. No the quote here from Leo on leader hospital. Talk good about what they need from the legislature. If they don't get it quote we may have to ration care. Or blow would that look. So I would tell what you do with these regions. Once promised to the next closest. Port Houston. And Jack that the so the people severe our nation's industrial work accident. And the victims of interpersonal violence. Would have there health care directly arms. If we don't level one trauma. That. Sergeant in training in the audience whether the LSU. In our option or rotate through our doors. We attract people internationally. To country and our trauma that. We'll talk about significant. That places. That trauma center at risk it places at. The training. That question in training at risk. Which means fewer possessions. To our community viewer and this to our community do you rate you're radiology technicians. Physical there occupational therapist. Helped care grade of our entire region. Breathing oil lamps item will be surprised to stumble on the governor June gold private times that says some 2013. And this article says spewed dispute the system and improved. Expanded services shorten wait times broader mix of patients with which medical students trying. No border is that true and if so long. If that if the funding doesn't come how much of that is affected. So you know. I'm very proud this day you know that I marched. With everybody from cherry hospital to the girl you know hospital to this new facilities the reverend Alexander. Hospital UNC. And would cheap. We. Are and we're expanding access and increasing the number that in June and before we need. Hundred billion dollars more to deliver care to a broken. That touched fewer patients. So when you start thinking about what we're going to end the educational environment for the next generation of care providers. We're doing our share and now buildings were in touch. We're delivering higher quality care to more people including accent. And yet being too old that would reduce. Support that does not make sense to me. They didn't send swollen gathered a look back over the show them we don't. That repeatedly Tuesday were in the bottom cured now actually for a whole list of health issues affecting its cancer obesity. Diabetes. And more. Seemed like a land please we'd blown cod is hell. Doctor wrote thank you for doubling as a veteran Sam that will duel album show hopefully we'll get to London to Greg. It are able gonna talk about this some more common back what do you think choosing 0187. Where all think about cutting health then I think what you think about cutting services. But it view or resident. And you know got a viable place to train robbery seven years. Do you go to the surrounding states that haven't had anywhere near the cops ordered not threatening to held cards that we are. Or do you say here. And if we get a number large number of them leave. Is that a general ration the doctor shortage. To those eggs or 187. Incumbent right back. WW. Should do you reading because and you were gonna do their show on cutting helped your columns in Louisiana. Those blown those burn out the Washington Post. Burnout among yours doctors is getting worse induces news the combined Saudi Mayo Clinic American medical and so skewed. Sure those positions were worse off today than chose three years ago more than half of them. Felt emotionally exhausted. Ineffective more than half up sort of work it's less than meaningful. And ended and would owned in much more to fuel. But I remember thinking. Suppose you were resident here in Louisiana and you've got seven years of funds and pro quality of Trenton. And every time hundreds of legislative. Session. We're getting cut everything in sight will begin we're gonna cut dogs on to relay your name we're gonna cut everything. Showed an old shoe football in that it becomes. Actually we're gonna have got these five things. And then it becomes the tools that they always do. Hiring education and health care. And when you have the results of we have in education in this state and and hope care. You get to a point where which resident. Says I gonna give me some of that and easy. Because. I don't know if the manager of the hospitals can stay in place because it threatened to break the contract that being broken. By the legislature. War if what I am doing is gonna get caught reduced. In in funds to such an extent. I don't get ads were adequate education. With all that so. Doctor road Jeffrey want assurances. Susie dean of graduate medical education generally and had to be internal medicine residency. Program. Doctors thank you breathe some unknown to much beat biz. Like it should be here or right might question. I'm a resident Republican 37 year watch him much good would come to this state. Well I think you're touching on and on several things have played. In altogether you know on that last segment. And also as an aside and don't just love listening to Peter W talked about it. In the Q and then talks have. You know the concerns about what's gonna happen with the hospital and then your earlier comments referencing that Washington Post article about burnout. You know cure your rent for the position planning out your career knowing that. These years of training really here and accept the trajectory of which workers going to be. If you're worried about what the future my education going to be than. And it becomes pretty high stakes and that people were saying words. Potentially I think realistic outcome of people choosing to go elsewhere and that has implications for the position pipelines for the state Louisiana. Which so both to explore with too little. You please please but until well wouldn't let me take a little bit early break here. And keep that thought because I would like to get the two Eagles so all the more true Joseph says. Cover red bag or talking to a doctor Jeffrey why each number we're talk big continual proposals. To cut funding to oh yen in the state. That's buried. Near the bottom of the barrel when we come Seth L column double up. Our bird finger about these continuing threats by the legislature. To caught held education now treatment. In the Saber on the reviewer doctor germ proved why so vote Tulane medical screw doctor you get meg could a very important point when I had date in wrote leaves content. Well he. You know it is sitting Peter alluded to earlier in Utah on the programs well for the past two decades. Louisiana's. Population health rankings have been close to mention and that's confirmed by the united health foundation in the commonwealth. State scorecard to work. And a big part of is is access to healthcare. At the trigger on this four point six million people in Louisiana. 111000 positions. That racial places Louisiana pretty much of the thirties thirtieth ranking in the United States in the wake of acts. The the scary part. Is that roughly 4045%. The position and Louisiana. Or at what we call retirement age that is greater than 56 years stage. And that's the twelve oldest position workforce the United States. Now just because the work forces of these retired doesn't mean that they will. But the risk of positions taking early retirement on predicting it's gonna escalate precipitously in the skips to burn out point earlier. With the advent of many of the new requirements of the affordable care Acxiom console which support because I think it will meaningfully improve quality and along long run. But things like macro met spree characterization regulations 600 citrix that are. And leading a lot of senior positions to say you know. An opposite not this practice is not like what it first started and I'm tool to start again. So. That into account and then add in the fact that the number overly patients. In Louisiana's course to double by twenty Saturday. And in the 450000. New positions which has support. In the wave Medicaid expansion. You're left with a fairly critical question how we want to replace this position. Pipeline are workforce in Louisiana for the next one to two decades. The answer is to ensure. The university medical center. But what can you. I mean again I go back to him. You get that big beautiful hospital your numbers from the medical center. Management there at least in the path in management at other hospitals. Have talked about Walken waved from their contract because you're gonna be violated. If the legislature. Keeps cutting to fund. Yep and I think that's the scary burger you don't let me put it is way I'm animal referenced charity in and university medical center. American ports are considered them to be the same I think as Peter alluded to as well. But if you sit effects for you know there 483 medical students it was in each year. 80% of those medical students were gonna do some part of the training in person. 2200 residents went in each year 60% of those gonna train at university medical sooner. But here's the key. 70% of all practicing positions in Louisiana that a portion of their training at the university medical side. You can take it one at two. Either. It's really hard recruit positions to Louisiana. War but the quality of the training that they're getting at the UNC or in years yesterday's cause and the Saturday. And I think that it's probably below. So what it comes down to is that if we can't sustain meaningful training at the university medical scanner. It becomes a very dire situation in the way of replacing that position pipeline that doesn't just benefit no more violence or that tanner. We would benefit all of us as Louisiana and across the state. As. Told doctor don't you in the first half hour. Ahead in the head of the house appropriations. Committee on a couple of days ago. And he's surprised me and when. I quoted the 600 million dollar deficit figures in that the legislators. Religiously. Sure is fighting. And he said none of them that's not a valid number he said what drew hearing into what they want. All of these different in to the war. These are we've got the money you pour of their budget the way it blogs land each year. But they won more and we don't have the money for that can you make duel on last year's budget. You know it's going to be tough and particularly when you're then again 450000. Knowing it's not all in and the war ones. Wandered through 2000 people that are accessing health care system as part of Medicaid expansion. This is already sooner and and there's perception out there that the two big. There's little ways than one but you know as Peter alluded to you know from 2004. And now. They're saving hundred million dollars a year. Let me give it on the finances we go into the residency. Perspective just to seek an appeal. You know rent and so. It is actually time training. But it is also would think it is salaries abruptly 50000 dollars which. People out there might have a lot but you know not consider the work in radio work week and I have many of them 200000 votes mourns student loans. But you add in the cost to benefits malpractice this is what it cost me as somebody from the two inside and again you know 4050%. Over. Residency efforts going to be at the university medical scanner. To get in all of that cost me about 90000 dollars per resident. To train them per year. Now residency positions shortly funded by federal Medicare dollars a so their direct and indirect payments and won't get into the details about the both proportional percent of Medicare patients. That you see in that facility. So bullet down and do compare contrast. If you take a fully private hospital fortune city hospital acts that in the community with a good player next in a very. Percent of Medicare patients that are coming there. Most of the residents peacocks are going to be paid by the federal government so we use one private hospital that somewhere in the state name. But as an example they receive 143000. Dollars per resident from seeing massive each year more than enough to cover the residents Cox. And because the paramedics and so good in the way to presently insured but directly or virtually compensated by what they're billing in the press insurance companies. The note that the university matter sooner this is what they're up against. Very little Medicare penetration rate why because poverty significantly reduces the chance to terminally sixty. So the federal funding per resident and UNC is not a 143000. Dollars it's 33000 dollars. Which leads me 67000. Dollar short per Lawrence that. And the only way to paper that is by and I'll just make in the point that. These positions again are going to these residents are going to be beat the State's position pipeline this is that public good. And the only way to ensure that public school of position pipeline. His by public support. Number continuance seals in the two in hospitals not that much different. But it really comes down to numb this is not just say what's good for indigent healthcare today. I think there's some moral implications. Of that as a standalone. But independent. The truly boils down to where we going to be in ten to twenty years. And I don't mean to Teddy girl and the sick people don't work. And so where people are working their property tax. And so you wonder if 1020 years down the road where we have. An aging population that's doubled more people on Medicaid. We can't fulfill that position pipeline. Inspector not going to be an even bigger economic maps. My guess is probably yes it would make this from the court around where. Doug was so I guess actually you puke will be doing this show again thank you did just unbelievable to Arab League call you again. Agreed to. Thank you grow. Come right back stay where it says I mean. You remember the big flap on the bombed care home and what the rationing care. Well attended statements by. Three of the agency's ruling hospitals. Bettors say if we don't get the you've requested by name and shouldn't. We may have to ration care. Or rethink our deal with the state and governor Edwards already is and he doesn't fraud re negotiated the contracts. I don't know do you know. Other mobile state would lose. And don't go always. In the new moon is net you've probably heard by now. It appears friends died from an open yours and Albert goes it's. In talk about what needs to change. Added to your editor all ongoing relationship. With the thirteen year old student. And these students. Parents approval. At a more comfortable thanks have a great day and thank you for listening this is WOBO. Brigade celebrity AM local 53. At him.