New Leader Sheds Light on MGH’s Upcoming Challenges, Opportunities- BWH Bulletin - For and about the People of Brigham and Women's Hospital
New Leader Sheds Light on MGH’s Upcoming Challenges, Opportunities- BWH Bulletin - For and about the People of Brigham and Women's Hospital
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December 27, 2002
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In This Issue:
A Forecast for the Future of Health Care
A Discussion with Gary Gottlieb, MD, MBA, BWH President
Hospitals and Health Care Workers Not Immune to Current Incoming Challenges
New President Provides Long-Term Outlook for Partners
New Leader Sheds Light on MGH’s Upcoming Challenges, Opportunities
The National Face of Health Care
Modern Challenges of Medical Education
MGH’s next President Peter Slavin, MD, offers Bulletin his insight on what is in store for the Partners co-founder.
MGH and BWH have both been successful over the last several years. What are the keys to extending that success?
Slavin
: Both the MGH and BWH are truly outstanding institutions. I think we need to continue building on their successes. Both hospitals excel at all parts of their missions – they deliver excellent patient care, they conduct superb research, and they offer among the most competitive training programs in the country.
Being part of Partners HealthCare also serves to enhance and strengthen both of these academic medical centers. Not only does Partners enable us to share ideas and best practices, but the ability to think and plan as a system has helped all members of Partners address creatively and thoughtfully some enormous challenges that lie ahead.
For example, we have tremendous financial hurdles before us. Internally, both the MGH and BWH are quite full. We’re at capacity, and that makes it very difficult to grow the way we need to. Both institutions are now building or planning to build new facilities that will help make some additional growth possible. But capacity issues will no doubt continue to challenge us. Externally, it is clear that expenses will continue to go up. The costs of pharmaceuticals, blood products, labor, supplies and equipment have been – and are expected to continue – rising significantly. The revenue per unit of service that we’re able to generate from our patient care activities clearly is not going up as fast as our expenses. Being part of a vibrant health care system gives us more flexibility to make decisions that can help us through challenging times.
In your view, what do MGH and BWH have in common? How do they differ?
Slavin
: The MGH and BWH have a lot in common, specifically their unwavering commitment to their missions of patient care, research and teaching. As I said earlier, both institutions excel at all areas of their missions. There are some people who say that the two hospitals have very different cultures, but frankly, every institution has its own “culture,” its own distinguishing features, its own history. I think the similarities between the MGH and BWH far outweigh the differences.
The two hospitals do differ somewhat in the markets they serve. The MGH has traditionally drawn more patients from the north, while BWH has drawn more from the south. The BWH also has gone through a series of mergers in the past, while the affiliation with another institution is a newer issue for the MGH.
As a renowned medical center, what does MGH bring to Boston? The region? The nation? The world?
Slavin
: The MGH and BWH both bring outstanding clinical care, research and teaching to the city, region, nation and world. Locally, I think these two hospitals are seen as crown jewels in Boston. The pioneering research that is ongoing in the laboratories of both medical centers has stimulated the economy through the development and growth of the pharmaceutical and biotech industries in the region. In addition, the MGH is the largest private employer in Boston, so the hospital clearly offers job opportunities for people in the region.
The MGH, like BWH, is a major referral site because of the quality of the care provided and the talent and expertise of the clinicians who practice at these institutions. A direct result of this unparalleled medical expertise is the fact that we draw people from around the country who want to work here. They come here to train, and often they stay because they are challenged by the work and inspired by the people around them.
How will MGH's teaching and research missions evolve in the years ahead?
Slavin
: There is a great deal of excitement right now in research at the MGH. Certain MGH research programs will be moving into a new building that will be built next door in Charles River Plaza. While traditionally research at the MGH has been focused within departments, the new research space is being designed with the idea that there are exciting opportunities in cross-cutting multi-departmental programs. The building will house such programs as genetics, physiologic genomics lab, computational biology and regenerative medicine and tech-nology.
The multidisciplinary efforts in research across Partners, such as the Center for the Integration of Medicine and Innovative Technology (CIMIT) and Partners Genetics and Genomics, have also been quite exciting. We are fortunate to live in an extraordinary era of medical progress, and the breakthroughs that are likely to occur in the next few decades will be monumental. I am excited that the MGH and BWH are right at the forefront of this incredible revolution in biomedical science.
On the education front, we are working hard to ensure that our programs are in compliance with the upcoming duty-hour regulations for residents. In addition, we should take a fresh look at our residency programs, which are excellent and highly competitive. We should adopt the philosophy of Honda, “If it ain’t broke, then break it.” The residency program model we use today was developed nearly a century ago when medical science and health care delivery were quite different than today. The MGH and BWH are in an ideal position to review and modify our training programs. And the time is right to do so.
If federal and state reimbursement rates continue as is, what is the prognosis for the health care industry?
Slavin
: I think the prognosis is somewhat grim if nothing changes. And looking across the horizon, there is not a lot of good news out there regarding Medicare and Medicaid rate increases. It’s absurd that hospitals and physicians are expected to lose money when they provide vital services to people who need them. I don’t know of any industry other than health care that is forced to accept rates that are below the costs of doing business.
If the public payors don’t provide adequate and fair reimbursement, then the burden shifts to the private sector. And the demands for fair payment that providers place on these private payors will increase significantly. Similarly, private insurers are likely to have a difficult time growing at the rate necessary to pay for the health care needs of patients enrolled in their plans. In addition, the struggling economy places an additional financial burden on these private insurers, as companies and industries cannot afford the premium increases and may be forced to cut back health care benefits or eliminate them completely. Clearly, we are in for challenging times in the years ahead.