Hospital's health could be key to region's development

BY Amaris Elliott-Engel / The Citizen
http://www.auburnpub.com

Dr. Deborah Geer thinks a low-interest business loan or incentives to see the uninsured or underinsured would benefit her practice.

“As the new person in town, you get a lot of people who’ve fallen through the cracks. It’s a great way to build a practice,â€? Geer said.

The general surgeon has been practicing in the area since April. She came because she had a lot of personal ties to upstate. Geer would like to retire here.

But she said public policies like loans with lower rates than commercial rates or other incentives would help make her practice a sustainable success for the future.

Retaining Geer and other physicians already practicing at Auburn Memorial Hospital, as well as recruiting other physicians in under-served specialties, is one of the seven goals identified to improve the Cayuga County economy by the Call to Action: Blueprint for Our Region’s Future working group.

Officials argue that the financial vitality of the hospital has a ripple effect for the larger community. The hospital is a major employer and high-quality health care can be a factor in investment decisions by businesses and younger people’s decisions on where to raise a family.

But health care dollars have migrated to other communities with some physicians no longer admitting at AMH or with patients in need of specialty care not available in Cayuga County having to get that care outside of the county.

And for the hospital to stay in prime health, it must have an adequate number of physicians with the key role of admitting patients to the hospital.

“The beginning and the end of the equation is to have the right physician teams located and participating in Auburn Memorial Hospital,� said State Sen. Michael Nozzolio, R-Fayette, who coordinated the professionals behind the Call to Action report. “The future of health care depends upon us recruiting to staff the needs of our patients. Hospitals, that are in my district, that have maintained their viability and their strength have been able to recruit physicians and keep them practicing in the community.�

“Health care is a major economic engine for most communities, no matter what the size,â€? said C. Mark Gregson, AMH’s interim chief executive officer. “Usually, it’s a very, very significant piece in a community’s economic viability. So goes the hospital, so goes the town. Communities where they’ve done well offer a base for recruitment, not only for health care services. It’s a major factor in people’s decisions on where to live, even where to locate businesses.â€?

The Call to Action group argues that the local community can help the hospital recruit physicians.

Guy Cosentino, executive director of Options for Independence non-profit and who led the physician recruitment part of the Call to Action Group, notes that the local health care, business and public sectors have partnered in the past to recruit physicians, including the Women’s Health Specialists LLP on N. Seward Avenue in Auburn and a 1950s-era business recruitment plan to entice post-World War II physicians to relocate to Auburn with tax and other incentives.

The Call to Action group is proposing that sign-on bonuses, relocation costs and tax abatements all be utilized to help with the recruitment of physicians. Cosentino also notes that overseas doctors working on temporary visas could help with some specialty shortages.

The results will be retention of health care dollars and lowering health care costs by emphasizing preventative care that is less pricey than emergency care, Cosentino said. Cosentino also is a columnist for The Citizen.

The hospital already provides an income guarantee to physicians that if they stay for at least a couple of years, the hospital will guarantee the same level of earnings they had in their old location as they undergo the expensive transition of opening a new practice and get to know the community, Gregson said.

The local community could develop contingencies to help with employment of physicians’ spouses, Nozzolio said.

The Call to Action group will be exploring the development of a business plan, including various incentives, for the recruitment of physicians; the plan would have roles beyond local health care providers for the wider community and local governments, Cosentino said.

AMH is focusing recruitment on four specialties with shortages: ear/nose/throat physicians, gastroenterologists, orthopedists and vascular surgeons.

Hospital officials believe that recruitment should work toward two goals: expanding the number of practitioners in under-staffed specialties and ensuring there are younger specialists to prevent a depopulation in some specialties as older doctors retire, according to Dr. Saul Rosenblum, the president of AMH’s medical staff, acting medical director and a member of AMH’s board of trustees.

“We think that having younger physicians in this area to provide services that have subsequently left, and the larger physician base would improve the financials at the hospital,� Rosenblum said.

The hospital has pursued some strategies to improve the physician shortage problem. It has successfully recruited physicians to rebuild the general surgical and anthesiologist pool. The institution of an in-house hospitalist program in the last couple of years, Gregson said, has eased strain on the emergency room and has allowed primary care physicians admitting patients to have the patients managed on their behalf without having to take call. The hospital is also seeking to woo back physicians who are based in the area but have stopped admitting to AMH in favor of Syracuse-area hospitals, he said.

While income guarantees and sign-on bonuses may initially entice physicians to the area, there are other factors that retain them, Rosenblum said.

He points to the collegiality of AMH’s medical staff, the area’s lower real estate costs and positive environment to raise a family, and the impetus to improve the hospital’s technology, including renovation of the operating rooms and the interconnectedness between the hospital and physicians’ offices.

“Ultimately, it’s the other things that will keep them here,â€? Rosenblum said.
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