The
health care sector presents a decidedly mixed picture
in the Delta in mid-2003. Certainly, Delta residents have
access to the latest diagnostic and treatment technologies
to the region, often eliminating the need to travel great
distances for sophisticated care. Specialized providers,
in markets such as home health care and medical equipment
and supplies, are meeting the needs of a population which
is generally getting older and increasingly dependent
on various health care options.
Still looming large, however, is the liability insurance
crisis, making it ever more difficult for health care
professionals to practice. Perhaps just as problematic,
certainly in the long run, is the serious shortage of
nurses and other technicians. These are challenges which
are not limited to the Delta, or even the state as a whole,
but the region is suffering from these pressures at least
as much as other parts of the country.
On the positive side, a number of area health care facilities
are expanding their facilities, their services, and even
their staffs. Jim Ainsworth with Baptist Memorial Health
Care system reports that the new emergency room and surgery
suites are now open at their Oxford hospital. “We’re
able to provide an elevated level of service to that community,”
he comments. “It’s a state-of-the-art facility
for this part of the country.”
At North Sunflower County Hospital in Ruleville, administrator
Joe Hammond says they are actively pursuing the implementation
of CT scanning services are part of the hospital’s
strategic plan. “We’re also very excited about
some of the relationships we’re developing with
the communities, such as the community health center in
Mound Bayou. We’re able to help provide more effective
and efficient services.”
Even in the current difficult climate, King’s Daughters
Hospital in Greenville is having some success in both
service expansion and the recruitment of specialists,
according to CEO David Fuller. “We have a new orthopedic
surgeon who brings a level of expertise which will both
complement and enhance our current services, “ he
says. “We also have a new interventional radiologist
who is really experienced with diagnostic and non-invasive
procedures.”
Phillip Clendenin, CEO of River Region Health Systems
in Vicksburg, says that one of the hospital’s primary
new developments is the opening of its Open Heart Program.
“We’ve brought in an excellent cardiothoracic
surgeon and recruited other staff to support him and the
program,” he says. “The program is unique-in
addition to providing open heart surgery right here in
Vicksburg, we’re also doing some procedures that
are not available in Jackson, such as endoscopic vein
harvesting. Rather than the incisions which typically
run the length of the patient’s leg, this procedure
is accomplished with only two small incisions.”
Todd Robinson is with Earl Swensson and Associates, the
architectural firm for River Region and other health care
facilities in the state. Robinson says design work on
a CCU expansion at the facility is in progress, part of
a master plan for the hospital which is designed for future
growth and includes plans for a new patient tower and
expansion of in-patient services as needed.
He foresees continued strong activity in the Delta region,
for reasons which effect the country as a whole. “People
need to understand that a lot of the existing hospital
infrastructure in general is becoming obsolete, or proving
to be a burden to providing efficient health care,”
he points out. “Also, the population is getting
older. A big mistake years ago was the thinking that there
was not going to be as big a need for in-patient beds,
that everything was going to be outpatient services. Now
we’re finding out that more beds need to be provided,
and a lot of our current projects involve bed expansion.”
Among specialized services, Grenada-based The Wright Stuff
continues to grow as a provider of medical supplies, including
a wide range of home health care and rehabilitation products.
“We’re experiencing some growing pains,”
says Amy Wright, “but that’s a good thing.
We’re working on a new catalog to combine all our
products, adding more of the types of items that are doing
very well, and more styles of hard-to-find items.”
Wright says the firm is becoming more involved in community
groups and working closely with various associations,
noting a particular need in the realm of Alzheimer’s
care. She adds that there is a growing need both for adaptive
equipment after surgery, and for caregiver products as
that part of the population grows.
With an aging population comes an increased need for home
health care services, says Clara Reed of Mid Delta Home
Health in Belzoni. The firm celebrated its 25th anniversary
in March of this year.
“We take a holistic approach to patient care,”
says Reed. “We try to take care of all their needs
and provide all the services we can. In addition to nurses
for skilled care, and all types of therapists, we also
have a full-time dietician-we feel that’s an important
additional service.”
Hospice services are also available from Mid Delta, and
Reed comments, “Many people mistakenly think that
hospice services only apply to patients who are going
to die in a very short time. The reality is that hospice
care is for patients with a terminal illness that is progressing,
but whom still need assistance. Often, this allows them
to stay at home with family and loved ones.”
For all the commitment to health care excellence in the
Delta, and the projects and programs underway to maintain
the top level of services, however, there are serious
challenges which threaten to undermine these efforts.
Perhaps none is as serious as the continuing crisis in
liability insurance, which in many ways seems to be getting
worse.
“This is the biggest issue for Mississippi physicians,”
states Jim Ainsworth. “Not only does is hurt recruitment
efforts, it is hurting existing practitioners as well.
Premiums have in many cases quadrupled-for some the premiums
now equal their annual income.”
Ainsworth says Baptist Memorial Health Care is looking
into alternative ways to provide malpractice insurance
for hospitals and staff. As to tort reform efforts, he
comments, “The window of time has now passed for
litigation to be filed under pre-tort reform guidelines,
so at least we know what’s in the pipeline. But
it will still be two or three years before it levels out.”
“The situation is past being called a crisis,”
states Noel Hart with King’s Daughters Hospital
in Yazoo City. “We have one surgeon who cannot operate
because he cannot get affordable insurance, and I worry
that a lot of doctors will leave the state.”
He agrees that it is too soon for tort reform efforts
to filter down, saying that they will have to be tested
in the courts before the insurance companies consider
coming back to the Mississippi.
Says Joe Hammond, “All hospitals share similar challenges,
whether in the rural communities or the larger towns-trying
to provide the same or even higher levels of service in
a climate not only of higher costs, out-of-control insurance
premiums, and reduced reimbursements. Hammond does report
one positive development to come out of the crisis. “We
have a physician who lives in Ruleville and practiced
in a nearby town. Faced with malpractice insurance costs,
he decided on early retirement, but was able to work it
out with his carrier to be able to do administrative work.
So he is working with us now, and has given us access
to a highly-skilled resource that we wouldn’t otherwise
have been able to bring in.”
Reports Hallie Duckworth with Mississippi Health Connection,
a statewide PPO network, “One hospital in Mississippi
did a study which said that for every patient seen in
the emergency room, $75 goes to malpractice insurance.
That number is probably higher in the Delta.
“Something which really concerns me is the dramatic
increase in the uninsured population,” she continues.
“This is partly due to the high level of unemployment,
all the layoffs, etc. But as costs continue to go up and
is passed on to employers, even some of the employees
cannot afford to have insurance. A lot of lower and middle
income people are not eligible for Medicare or Medicaid,
but often cannot afford insurance, especially if the choice
is between insurance or housing and food.
“It does seem that Mississippi is ahead of some
states in looking into ways to address this problem and
improve the situation,” she says.
Another crisis which already effects health care in Mississippi
and indeed around the country is one which threatens to
be as damaging as the insurance situation, especially
over time-the critical shortage of nurses and other technicians.
“It is a chronic problem, “ says David Fuller.
“And now there’s an additional strain on the
nursing system, what with the multiple outlets where one
can receive care, and especially with the baby boomers
entering the health care delivery system.
“At King’s Daughters, we’re addressing
this in several ways. We support the nursing programs
at the schools, and support individual students through
scholarships. Beyond that, we work to create a level of
professionalism on a day-to-day basis which will make
a nurse feel he or she is an integral member of the team.”
Sta-home Health Agency is one of the state’s largest
and most recognized home health care agencies. Joan Hamilton
says the firm is addressing the nursing shortage internally
by putting added focus on recruitment and retention.
“We participate in nursing association activities,
go to the colleges, etc.,” she says, “and
sometimes we are able to pull people from these sources.
“The nursing shortage will be worse in the Delta–we
cannot offer the packages that larger cities and hospitals
can. So we’re focused on how to attract nurses to
the area and to home health care-and keep the ones already
in it, since it costs more to train new nurses than to
retain existing ones. In the long haul, the answer is
not money–it has more to do with job satisfaction.”
Says Phillip Clendenin, “Improving the nursing situation
really requires a grass-roots effort. We must work with
the young people to generate interest in the nursing profession,
and create an environment to attract people to Mississippi.
“One particular area of need is RN’s,”
he continues. “The average age of the RN is increasing,
so we will be losing a number of them in the coming years.
But there are some good programs. For example, we’ve
partnered with Hinds Community College to promote RN careers,
and we’ve been pleased that they are seeing record
enrollment in their program. It will just take several
years of that record enrollment to start improving the
situation.”
Region I Mental Health Center in Clarksdale provides a
wide range of services for persons with alcohol or chemical
dependency. It has one of the state’s few adolescent
residential facilities, and a strong program for expectant
mothers-one which allows them to bring their other children
along when coming for treatment. Executive director Newton
Dodson says that the Center has been fortunate in its
ability to attract qualified staff and retain nurses.
“Our concern is that the population is growing,
but the money sources are not,” he comments. “We
need more state and federal monies, and are looking with
great interest at what’s going to be available to
us next year. We need federal matching money for Medicaid,
because we serve a lot of Medicaid patients, and so it’s
a significant part of our budget.”
The challenges are serious, and the crisis situations
may indeed worsen before they improve. Still, it is clear
that Delta medical institutions are having some success
in overcoming the challenges, and certainly there are
a lot of ongoing efforts to make the health care climate
in the area more positive.
Sandra Burns is president of Mississippi Health Partners,
a managed care network which recently celebrated its tenth
anniversary. She provides a perspective which recognizes
some of the strengths which may help the Delta overcome
its health care challenges.
“As someone who has worked in other states before
being recruited to this position, I see a couple of advantages
Mississippi has,” say Burns. “For one thing,
Mississippi physicians are politically active and well-informed;
that certainly helps.
“And beyond that, even though it’s a tough
environment, the fact is that here we’re all close
neighbors who see one another at church and at the store.
By and large we have the ability to work out our problems
ourselves with a fairly good level of success.”
DBJ
