LOWVILLE Lewis County General Hospitals CEO says he is taking steps to address a rift with doctors while trying to rectify the facilitys fiscal problems.
Things have to change, said Eric R. Burch, CEO at the county-owned hospital since October 2007. The economics of the place has to change.
The hospital has engaged the services of Edward Enos, director of physician services at United Iroquois Select, East Syracuse, to review physician productivity and clinic operations.
Thats all he does, is work for hospitals and physician practices, Mr. Burch said.
Mr. Enos met last week with administrators, hospital-employed doctors and representatives of the board of managers and will meet individually with doctors over the next couple of weeks to observe their work flow and recommend improvements, Mr. Burch said.
A majority of the active medical staff in late July cast a vote of no confidence in Mr. Burch, citing in a July 23 letter to hospital managers the erosion of our trust in Mr. Burchs management and leadership skills. The letter, which was released to the Times last week, was signed by three officers. Dr. Steven L. Lyndaker, past president of the medical staff, said about two-thirds of the roughly 15 doctors present favored the motion.
Dr. David F. Rosner, current medical staff president, sent a letter indicating that he and five other hospital-employed doctors supported Mr. Burch, and hospital managers then gave the CEO a unanimous vote of support.
A statement during the same time period from Dr. Lyndaker to the board of managers, also released to the Times, indicated that doctors were upset with the unexpected firing of general surgeon Dr. James V. Stillerman and an erosion of respect between medical staff and senior administration. Dr. Lyndaker also recommended that a medical director act as an advocate for employed physicians and that a chief medical officer position be created to help maintain the delicate balance needed between administrative and clinical considerations.
To improve communication between administrators and medical staff, Mr. Burch said hospital officials may restructure the medical directorship to provide more direct administration of employed physicians and, possibly, have separate directors for the hospital and nursing home. The extra administration could cost more but may pay for itself with improved relations.
To address fiscal concerns, hospital managers have set a target of saving $500,000 annually from the budget, while administrators have implemented a freeze on capital spending, are conducting a coding and billing audit for clinics and are reviewing all contracts, discretionary spending and positions as they become vacant, Mr. Burch said. The contract review alone has saved roughly $60,000, he said.
Hospital officials also have met with state Department of Health officials to discuss the possibility of being designated as a critical access facility, which would allow for higher Medicaid reimbursement rates. Stroudwater Capital Group, which has helped other facilities gain that status, will assist the hospital in evaluating the option and determining if it would be feasible, Mr. Burch said.
We dont know what this will do to us down the road, he said.
The hospital also is seeking requests for proposals for an emergency room physician group and hospitalist service and is reviewing two responses already received, Mr. Burch said. The idea would be to contract with one group of doctors that could staff the emergency department while also handling after-hours admissions and initial treatment so family practitioners would not have to come in at night, he said.
Some doctors have privately expressed concern that the move could be used to get rid of the current group of emergency doctors, but the CEO said that the intent is to offer the best service for the community and local physicians and that the present providers could submit a proposal.
Mr. Burch said he has met with every department at the facility to discuss the fiscal situation and plans to continue meeting with employees.
On a positive note, the hospital has received a letter stating that $3.3 million in intergovernmental transfer funding, intended to reimburse health care facilities partially for losses incurred on Medicaid, uninsured and charity care patients, will be forthcoming Sept. 26, Mr. Burch said. That would be used to pay down part of the hospitals nearly $6 million debt to the county.