Wednesday, December 24, 2008

Christmas Spirit

It was the night before Christmas, and all through the hospital, not a creature was stirring, not even a mousenow that is not exactly true! First of all there are no mice and second there is a lot of stirring. There are nurses and doctors, lab and radiology techs, housekeepers and dietary staff…the list goes on and on. Although it is a little quieter than the average Wednesday, there are plenty of us here on Christmas Eve and Christmas Day. Disease and injury know no special dates or times. We are here 24/7 and ready for whatever may come. We will even be ready at the Fly High Fitness Studio and the Paul W. Ahrens Fitness and Rehab Center for exercise after all the eating that seems to come with the holidays!

This year Suzanne Cooner (vice president of operations) and her husband Russ decided to help with a special Christmas Day lunch and dinner at the hospital. With financial help from many others, and the support of our nutrition services department, a festive holiday meal is planned. Now this is nothing new for our employees working on the holiday, we often have special meals for them and their families. However, this year we invited any of our employees that may be alone for Christmas or may be struggling a bit financially and would appreciate an opportunity to break bread with other members of our team. Last I heard we are expecting around 75 to a 100 people!

Then there is the story of the family of six headed out to Washington State and involved in an accident. They wrecked their car, fortunately no major injuries, but now stranded in Grinnell. This family is having a tough Christmas…lost both their jobs and home in Indiana and so decided to sell everything and take a small U-Haul with what was left of their belongings out to stay with family all the way up near Spokane. Then the car gets totaled…now what? They found themselves in a place where good ol’ Iowa hospitality is alive and well. Iowans rally to their cause of course. They help with food, hotel bills, and ultimately a bank kicks in to fly them out to their relatives. I heard one of our staff members talking about the fact that the family sold the Christmas gifts to help pay for the long car trip out west. Next thing you know, folks around here start raising some funds and Brenda Peck and Lisa Cowan (two of our employees) headed out to buy some gifts! They said the kids jumping up and down would bring a tear to the eye!

People making a difference in the lives of others…whether it’s life saving medical treatment or in this case just good neighborly care and compassion for a family of strangers in need of a big Iowa hug.

For me it is pure joy to be associated with so many caring and dedicated people. If that doesn’t get you in the Christmas spirit, I don’t know what will. I would like to wish a Merry Christmas and Happy Holidays to your family - from ours.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Friday, December 19, 2008

When Disaster Looms Large

Disaster…a word that can elicit a shot of adrenaline for most folks! For those of us who work in a hospital, the word “disaster” is often a call to action. Over my 20 years as a hospital CEO, there have been plenty of disasters…most are natural disasters. As I write this we are experiencing a winter storm that began with ice, turned to sleet, and is now snow. I am not sure exactly what I will find in the morning. The phone may ring before the night is over.

This storm brings back memories of one disaster in particular: the ice storm of 2007! I first realized it was going to be a very long day when I was awakened by the sound of cracking limbs. My two large soft maple trees were literally tumbling down around my house. An inch of ice covered everything. It took a half hour to free my windshield of ice so I could begin my 25 mile journey to the hospital.

Suzanne Cooner, one of our vice presidents and the administrator in charge of any and all disasters, had already initiated our disaster protocols and set up a command center. (Interesting factoid: Suzanne is trained at the highest level of incident command…a very reassuring thing to have someone so skilled when it comes to disaster. In fact we call her the “Queen of Disaster”!)

We had three priorities for us that day:

• Deal with the widespread power outage.

• Get enough staff to the hospital to meet the needs.

• Reach out to those with special medical needs in the community.

It was cold, and warming shelters were needed. Those who rely on electronic medical equipment to maintain their health needed shelter with electricity. Eight couples with such needs took up residence in our OB unit while they waited for power to be restored to their homes.

The conference room at the hospital became the incident command center for the county. Volunteers and staff made welfare calls on thousands of people in rural Poweshiek County. Public safety officers would be dispatched to bring those who needed help to shelters. It was a massive effort with multiple agencies working together, just like we had practiced through drills many times before. In fact, Governor Culver and Adj. General of the Iowa National Guard, Ron Dardis, stopped by to see the operation in action and declared it a model for all counties.

This week, Tom Newton, director, Iowa Department of Public Health, stopped in for a discussion with all those involved in emergency preparedness in Poweshiek County. Tom and I serve together on the University of Iowa College of Public Health Advisory Board. I have been impressed with his leadership. He is a great public health leader and I appreciate his effort to get out into the state to see firsthand how we prepare for emergencies.

Many of our local public safety agencies were represented at the meeting with Tom, like Police Chief Jody Matherly and Fire Chief Dan Sicard; Mayor Gordon Canfield and State Senator Tom Rielly; EMS and County Emergency Management leadership; and of course many of our hospital staff. The meeting was led by Chad Nath, GRMC emergency preparedness director. (Incidentally, I call Chad our MacGyver – one of the handiest and ingenious guys I know!) He gave a presentation about the ice storm and what a magnificent job we all did working together to meet the needs of our community. Director Newton declared that our work in Poweshiek County was indeed a model for the rest of the state. IDPH Deputy Director Mary Jones was also on hand for the meeting. Mary is responsible for the trauma certification system in Iowa and she praised our trauma system from the onset of the rating program through to present. She said that if she were in an accident in the State of Iowa, GRMC would be one of the hospitals where she would want to receive her care. We were actually the first hospital in Iowa to go through the certification process a decade ago. I am very proud of all the dedicated women and men at GRMC who put the lives of others first in the face of disasters.

The truth is we really never know what tomorrow is going to bring: a chemical spill from an 18- wheeler on I-80; a tornado or major wind storm; a massive explosion or fire at one of the industrial sites in the area; or a senseless act of violence against innocent victims. What I do know is that the hospital, working hand-in-hand with many other agencies, stands ready to jump into action to serve others. We tuck our families into the basement and head to the hospital in the middle of summer storms. We work 24- and even 36-hour shifts until the job is done. We deploy our practiced skills and talents in the face of danger and personal risk, all in the service to others.

Being one of the best in the state doesn’t just happen. It takes dedication, education, and training; reaching out to other agencies; a desire to serve; and a little sense of adventure. Fortunately, we have all those things and I am proud of the team at GRMC and all our colleagues in Poweshiek County. I know I will sleep well tonight even with Mother Nature up to her old winter tricks, because I know we are ready. Can’t wait to see what will happen when winter officially arrives next week!

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Friday, December 5, 2008

Stress, stress, and more stress

Stress, stress, and more stress. The life of a rural hospital CEO can sometimes be rather stressful. This week, the focus has been on dealing with the difficult financial challenges we are facing. Thirty-five percent below cost Medicare payment, a very tough economy and lower patient volumes all contribute to a big negative bottom line! We are determined to keep our focus on our mission because we know the work we do is vital to individuals, families and the community as a whole. We also know that it is our employees, physicians, volunteers, and board members that make that difference. The work we do is fundamentally about people interacting with compassion and skill. It is deeply personal. So too the business side of a hospital can’t lose sight of the people. I take my job seriously when it comes to the people who work here. I know they depend on the hospital as an employer. And the hospital depends on our people to bring our mission of service to life. It is really that simple…but often stressful trying to make it all work.

I use HeartMath, a routine massage, a glass of good wine and good food, time with family and my faith to help with this load. I also look for humor in my day! This week, I spent a few hours with Mark Doll (our facilities management director) working on our waiting rooms. It seems chairs had been mixed about and the spaces simply looked a bit disheveled. We moved things around and both felt much better about the spaces we have people waiting in at GRMC. We did find two really old, and I mean ancient, patient room lounge chairs in one of our lobby spaces. They were really ugly. We were going to simply retire them. Then we had a brainstorm…let’s put them in someone’s office. We headed to our imaging director, Kevin Kincaid’s office and removed his side chairs and replaced them with these two “vintage” and/or “classic” chairs with a message of congratulations. Well, when I went to my car this afternoon, on a tip that I had a low tire, the picture here is what I found! What a belly laugh…thanks Kevin for adding to my stress management program. By-the-way, I bet you didn’t get that up on my car by yourself! Mark…

I am very confident we will make it through this challenging financial time – simply because we have great people at GRMC. I am proud to stand side by side with them! (Even the jokers in the crowd.)

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Thursday, November 20, 2008

Called to Washington

It was a very long day yesterday. I got up at 4:30 to get to the Cedar Rapids airport to catch a flight to our Nation’s Capitol and I returned last night head hitting the pillow about midnight.

It all started last week as I enjoyed lunch with Congressman Leonard Boswell on Tuesday and Senator Charles Grassley on Thursday both here in Grinnell. Among other things, the focus was on what we could do to try to advance the legislation they both have introduced in their respective chambers. That led to a decision to call a meeting of both senators in Washington, D.C. along with Congressman Boswell. The idea was to put our three Members of Congress in the same room working together on this one issue. Well, the meeting took place this week on Wednesday in the U.S. Capitol. Congressman Boswell called and asked if I would come facilitate the meeting. In addition to the three elected officials, many of their key health staff members were there. About 11 people in all, including a member of the Iowa Hospital Association staff. Several other “tweener” hospital administrators from Iowa called in to be part of the meeting via telephone.

It was great to get our congressional delegation together and we discussed the serious state of things due to the dismal Medicare and Medicaid payment levels and the fact that there is a terrible inequity of payment. Some hospitals in Iowa and around the country paid at 101 percent of their costs and GRMC and the other seven tweener hospitals paid between 67 percent and 85 percent of costs.

We discussed two possible approaches to getting the legislation passed. The first is to wait until the Senate Finance Committee (Mr. Grassley is the highest ranking member on the committee as a Republican) works on the next full Medicare bill sometime next fall. The other option was to work with Mr. Harkin on the Appropriations Committee. Although this type of legislation would not typically emanate from this committee, both Senators agreed in this case it is worth a shot. Many of the legislative leaders in both the House and Senate would need to agree with this approach; but then again they all have tweener hospitals in their states as well. The appropriations activity likely will get back into full motion in January.

I really appreciated the efforts of our three Members of Congress coming together on a very busy day in Washington D.C. (this was the same day the CEOs of the Big Three Auto Makers were also in town to beg for financial assistance). We spent about an hour together brainstorming the best ways to try to fix this problem and help secure the future of middle-sized rural hospitals across the country.

I got a text message from Congressman Boswell as I was in a taxi headed back to the airport saying in part…”I thought we did well. We will continue to press.” I am optimistic that somehow, someway we will get this fight won!

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Tuesday, November 11, 2008

Saluting “The Greatest Generation”

Over the past year, Grinnell’s Community Education Council has been planning a salute to Poweshiek County World War II veterans. I am proud to be a member of the council for many reasons, but there’s no way I can say why more eloquently than George Drake did in his superbly written guest editorial in Monday’s Des Moines Register. Click here to read the article.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Family Practice Physicians and Pediatrics

I recently received an email inquiry about bringing pediatricians to Grinnell. I thought this was a good question that others may have wondered about. Here’s my reply about why we have not focused on recruiting a pediatrician to the area.

We do not have plans to recruit a pediatrician to Grinnell at this time. The reason is due to the strong family practice presence in our community. The truth is, board-certified family physicians are very well-trained in pediatrics in addition to the full range of family medicine. There is nothing a pediatrician does that is outside the normal family practice physician’s capabilities.

There are pediatric sub-specialties, just as there are with adults. A general pediatrician would also refer really sick children to pediatric sub-specialists at the same rate as a family practice physician. These specialists see patients at Iowa’s large teaching hospitals, Blank Children’s Hospital, or the University of Iowa Children’s Hospital.

There is absolutely no reason to take a child to a pediatrician over a family physician for routine medical care. In fact, you could easily make the argument that when a family physician is caring for the entire family for routine medical care, that physician is in the best position for diagnosis and treatment since the social situation that exists in most families greatly impacts diagnosis and treatment.

The American Academy of Family Practice web site,, has additional information regarding your question under the patient section.

I have always trusted and appreciated the care my children have received from family physicians when I have lived in Des Moines, Jefferson, and Grinnell. We are especially blessed in Grinnell with many outstanding family physicians. I can wholeheartedly recommend them to your children’s routine medical care.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Thursday, October 30, 2008

A Great Time Was Had By All

Last Thursday evening, I got to attend the Women's Health Focus with about 480 women from the area. Nearly 30 organizations and GRMC departments had educational displays and health information to learn more about all the great resources we have in our area. That’s me on the right side of the photo in the exhibit space.

My highlight of the night was listening to Peggy Kline, the keynote speaker. She was hilarious in her delivery of an important message. Women need to take the time to treat themselves well, like royalty, in order to do all the things women do for their families, friends, career, and more. Peggy’s the one wearing the robe and crown. I have to admit at first I was a little uncomfortable as the only male in the audience…but I soon found myself laughing and appreciating some of the challenges that women experience.

It was fun seeing so many people attend this great event. My special thanks to Jennifer Cogley and Shannon Reding for their leadership on this project, along with all the GRMC staff and Auxiliary.

Next year, we will have to find a larger place…I can’t wait.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Tuesday, October 28, 2008

Good News!

With my job, there are ups and downs like most jobs. The last several months have been mostly ups as we are having some great success adding to our already strong medical staff. I actually really enjoy physician recruitment. It gives me a chance to brag about life in Grinnell and Poweshiek County and about the wonderful women and men that call GRMC “their” hospital. Frankly, it is not hard to talk about all the benefits of life in our community and usually if I can get some one to come take a look, they immediately get excited about the possibilities. Now we don’t make an offer to everyone that visits us. In fact, it often becomes apparent that some candidates are not “a good fit.” Occasionally we do find the perfect person who will bring their many years of training and education to our medical center. Of course it takes more than skills to compel us to make an offer; they also need the attitude of service and team approach to truly be the right fit.

I have great news to share regarding our physician recruitment and retention activities. First, let me focus on anesthesia and pain medicine. Early next month, Kevin Emge, DO, will join Ken Whipple, DO, in anesthesia. Both are very well trained and have wonderful personalities. Dr. Whipple has been here since August and has been an excellent addition to our medical staff. We look forward to welcoming Dr. Emge and working with Alex Anderson, CRNA, in a continuing role in this department. Alex has done a super job providing anesthesia services here and we hope to have her join us in a permanent role at GRMC.

Bojan Pavlovic, MD, started his pain management practice earlier this month and has already established himself as a first-rate physician with an attitude of service. Originally from Chicago, this Midwesterner is eager to bring our pain management program to new heights and we are very glad he is here.

I have some very exciting news regarding internal medicine. We have signed a long-term agreement with Christine Lindgren, DO and she will start in mid-January! Some of you will remember Dr. Lindgren when she spent the better part of a year as a medical student here with Dr. Doorenbos. After her residency in Des Moines at Iowa Methodist, she went to Marshalltown and has practiced there the past several years. The medical staff members involved in her recruitment are very pleased as she will be instrumental in rebuilding our internal medicine department.

We have another strong internal medicine candidate also interested in joining our medical staff. She has been here for one visit and we are working on a second visit including Dr. Lindgren. If this candidate proves to be a good fit, she would be available to begin here in August.

On a side note, we have come to an agreement with Mercy Medical Center to provide E-ICU (electronic intensive care unit) services to GRMC slated to begin in February. This service essentially provides critical care services to our ICU and ER with real-time video and electronic connection to patients. This will allow our physicians to have access to board-certified, critical care physicians for consultation and monitoring of patients. This service will be particularly beneficial at night and give our physicians some relief from what can be a vigorous call schedule. There will be much more information about the E-ICU in the near future, however I mention it at this time because it was very helpful in internal medicine recruitment.

We have one physician departure to report and that is Renee Kirk, DO has decided to leave GRMC and join the VA Hospital in Des Moines in emergency medicine. We thank Dr. Kirk for her many years of service here and wish her all the best in her new role. This change did open up a full-time ER position and James Dy, MD has signed an agreement with GRMC to fill that position. Dr. Dy is no stranger to our medical center and is excited to be back in a full-time role here in Grinnell. He plans to move to our community next month and get started in December.

You are also aware of the three new physician assistants we added over the past several months including: Sarah Feddersen, PA-C in urology, Jarrod Phelps, PA-C in general surgery, and Kristin Leonard, PA-C, in family practice. All three are excellent additions to our team and we welcome them all.

Finally, we have two orthopedic surgery candidates we are vetting with the Iowa Orthopaedic Center. In addition, Surgical Associates has a general surgery candidate they are making arrangements with to visit Grinnell in the near future.

All in all, it is a very exciting time for GRMC on the recruiting front and we are very pleased to be adding such outstanding physicians to our medical staff. If you have any questions or comments, as always, please feel free to contact me.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Friday, October 17, 2008

Bringing the Farm to the Workplace

GRMC and Grinnell Heritage Farm were featured in a Des Moines Register article this week about our CSA program. (CSA stands for “community supported agriculture.)

Click here to read article

GRMC teamed up with Andrew and Melissa Dunham of Grinnell Heritage Farm to provide hospital employees with a weekly box of fresh vegetables from the farm for up to 17 weeks. While delivering CSA boxes to workplaces isn’t unique to GRMC, the fact that GRMC invested upfront in the CSA is new. In order for the farm to make plans for the growing season and pay for the costs associated with planting, shareholders need to pay in advance for the share. GRMC recognized that writing a check for $400 would likely be a barrier to many employees, so the medical center paid the upfront cost and allowed employees to pay us back through payroll deduction. By doing what we can to help employees focus on their health and wellness, GRMC has healthier employees and our health insurance usage has decreased.

I’ve enjoyed getting my weekly box this spring and summer. There have been several new things I have tried that I might not have picked up in the grocery store and things in the box that are simply not available through a retail store. As one of our employees said in the article, it is like having a garden without having to do the work. Our weekly share ended last week and I’ll have to get used to buying my produce in the grocery store again. I’m already looking forward to next year.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Tuesday, October 14, 2008

Never Too Young To Start Saving

I got to do something really cool today. I was able to be a part of a special presentation to a baby boy born at GRMC. Owen Blankenfeld, son of Cory and Alicia of Grinnell, was born at our hospital in August and he was selected at random to win a $1,000 college savings account as part of a giveaway program through the office of the State Treasurer of Iowa. While the giveaway program is for babies born at participating Iowa hospitals, anyone can start a college savings account through the Iowa 529 College Savings Program through the state. You can get more information by clicking here Anyone can contribute, including parents, grandparents, friends, and more. It all adds up. As a parent of college students, I really appreciate the program and the effort to put aside money to save for an important investment in our children’s lives. Congratulations, Owen, and all the best that this new account can provide for your future.

Pictured in the photo are State of Iowa Treasurer Michael Fitzgerald, me, State Senator Tom Rielly, Alicia, Cory, and Owen Blankenfeld.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Wednesday, September 17, 2008

More Hospitals Offering Alternative Therapies—Are You?

John Commins, for HealthLeaders Media, September 17, 2008

A new survey this month by American Hospital Association subsidiary Health Forum shows that a growing number of hospitals are offering complementary and alternative medical services, or CAM.

Is your hospital part of this trend?

Click here to read full article.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Iowa Public Radio Interview

I was interviewed by an Iowa Public Radio reporter about the Medicare Tweener issue.

Click here to listen.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Tuesday, September 16, 2008

Alternative treatments serve a patient's mind, body and spirit

When nurses tried to insert an IV into patient Linda Aron's hand, she was so anxious over the impending operation to fix her acid reflux that they simply had to stop.

Instead of continuing to poke and prod Aron, nurses at Grinnell (Iowa) Regional Medical Center called in a massage therapist to rub her shoulders and arms to help her relax. Within 10 minutes, Aron had an IV in place.

Click here to read full article in today's USA Today

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Friday, September 5, 2008

“Tweener” Hospital Makes National Hospital Business Journal

Modern Healthcare magazine printed an article in the Aug. 4, 2008 issue that discussed the legislation Sen. Grassley introduced to address “tweener” payment inequity. There was our word, “tweener,” used in the article as well as our definition, “a hospital that is too large to be considered a Critical Access Hospital and too small to be a Rural Referral Hospital.” While we weren’t specifically mentioned, they clearly interviewed a member of Sen. Grassley’s staff.

Also in this issue was a very critical editorial written by David Burda, editor of Modern Healthcare. This editorial stated that this legislation to help tweener hospitals was “special-interest legislation of the worst kind.” The editor slammed the American Hospital Association for applauding Senator Grassley for his commitment to rural healthcare providers. In order to pay for the proposed new Medicare Part A classification, Grassley’s bill would restrict the number of physician-owned hospitals.

We don’t have many physician-owned hospitals in Iowa. There’s a clear for-profit financial benefit for a physician who orders tests and procedures done at the hospital he or she owns. The Congressional Budget Office indicates physician-owned specialty hospitals cost Medicare more than community-owned hospitals and are therefore a reasonable target for reducing Medicare spending and making payment to tweeners more equitable. We clearly have no beef with physicians…they are our hospital every bit as much as our employees, volunteers and board members. It is the doctors and profit minded investors that only build hospitals that provide the best reimbursed services, in essence skimming the profits on only well paid services and leaving the rest for the community hospitals. The competition would be welcomed if it was a level playing field and the physician owned specialty hospitals took all patients and offered the full range of hospitals services. Do you see specialty hospitals offering neonatal intensive care or burn services or even trauma services…only orthopedic, cardiac and imaging hospitals. If you are interested in reading the editorial from Modern Healthcare and our letter to the editor in response please email Denise Lamphier in our public relations department.

We continue to make efforts to make sure we get paid fairly. In addition to Senator Grassley’s bill which was supported by Senator Harkin as well, we have worked with Congressman Boswell to offer a companion bill in the House of Representatives. There are only three short weeks left in this Congress so the window is tight for getting something done this year…but we are hopeful!

I will keep you posted.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Upgrading Our Billing

Recently, GRMC started working with a different company to help us with patient bills and insurance claims. The reason for the change was to improve patient satisfaction with our billing and collection process so that patients would better understand what they owe, give them the ability to pay their bill online, and/or help them set up a payment plan. The idea was to find an organization that specializes in this complex and ever changing process and is committed to only doing billing function. They would then work with our employees locally that do billing. We would work together to have the best billing system possible.

Sounds great, but for a few folks we really got off on the wrong foot with this new system. We’re working through some technical difficulties with the transfer of data from our previous billing company. This resulted in some patients getting letters that said some had already recently received a bill, when they may not have. Statements didn’t include information that we expected it to include, and, to make matters worse, the website address on the statement was incorrect. The correct address is

We take quality service very seriously at GRMC from the moment you walk through the door to providing you with accurate and timely billing information. We apologize for the confusion and problems this situation may have caused a few of our patients. We also thank you for your patience as we correct this and move forward. We literally sent out thousands of bills and the vast majority of them were accurate and timely.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Friday, August 15, 2008

All in a Day’s Work

“Grill Days” happen at GRMC every other Friday for about six months out of the year. We get the grill out of storage in May and put it away in September—or October if the weather holds. Employees and departments take turns working the grill and serving up burgers, hot dogs, or chicken sandwiches that anybody can purchase. I love doing this. It’s fun to step out of my usual shirt and tie role to be outside and mingle with co-workers.

Grillers often pick a theme for their grill day. I invited Pete Lahn, chair of GRMC’s board of trustees, to work with me. We both ride Harleys and decided on a “biker” theme for our grill day. Here’s a photo of us today, a picture-perfect August Friday in Iowa. Standing with me is Carla DeGeorge, Mary Anderson, and Pete Lahn. Carla and Mary staff our Corner Café and really do a lot to help us all have a little fun at work.

Pete says this is a great perk for being board chair. And, he’s been super about volunteering to help serve employees for other events. During this year’s National Hospital Week, he organized a cookie break for staff from the board and also came in to serve a meal to the night shift.

Having a little fun at work is so important to building a great team and making this a place where people look forward to coming to work. I work with some really amazing people. That’s what makes me look forward to coming to work.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Wednesday, July 30, 2008

A Healthy Environment

GRMC is a part of a growing nationwide initiative designed to help hospitals and health care centers practice “green” medicine. What does this mean? Just like at home and in other businesses and industries, we are learning more about how we live and how we practice medicine impacts the environment.

At GRMC we have organized a “Green Team” of department managers, staff members, and an intern from Grinnell College, to identify ways in which we can make an impact. We are exploring ways in which GRMC can work with other businesses and organizations to be a community leader in this effort.

This is a long-term process and I’ll continue to share more about the work we are doing. The second line of our mission statement reads, “Genuine care and compassion for the health and well-being of patients, families, and the communities we are privileged to serve.” Doing our part to create a healthy environment goes a long way to living out that mission.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Monday, July 28, 2008

Bandaging Medicare

This week, Congress voted overwhelmingly to override a Presidential veto of a Medicare bill that prevents a 10.6 percent cut in reimbursement to doctors for Medicare services. The reimbursement cut is part of current law that must be amended to avoid this scheduled cut from taking effect. Congress has another 18 months before this situation comes up again, unless they come up with a plan for change. While this legislation is vital, it is a single finger in a dam that is about to burst.

The Medicare situation is complicated at best, and at worst, it maybe broken beyond repair. The current home mortgage foreclosure situation will seem of small consequence if we don’t overhaul the nation’s healthcare system. We absolutely must find a long-term solution.

Medicare is only one part of the system that is in serious need of repair. Add Medicaid, uninsured, and the rising costs of healthcare into the mix, and it creates a perfect storm. Reforming our healthcare system will be one of the biggest tasks we’ve faced as a nation.

Rushing into a solution is not prudent, but doing nothing is inconceivable. The rock and a hard place.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Thursday, July 24, 2008

The Rumor Mill

I’m always amazed at the power of the spoken word and how rapidly news can spread through a grapevine. Many people who use GRMC have shared their frustrations and disappointment with me about recent physician departures. I appreciate hearing from anyone who wants to visit with me about questions or concerns they have about the medical center.

A frequent comment I hear is, “all the doctors are leaving.” Well, in reality not all the doctors are leaving. Yes, we have seen several come and go over the past few years for a variety of reasons. And many of these reasons, such as better income opportunities, wanting to be on call less often, cultural challenges, living in a rural area, are some of the same reasons fewer medical students are choosing to go into family practice in a small town.

The fact is GRMC has an excellent medical staff committed to the medical center and the community. With nearly 70 credentialed staff, we still have more physicians than the typical hospital. This includes 34 active physicians, 14 visiting specialists, nine mid-level providers such as physician assistants, nurse practitioners, and five affiliated providers.

Here’s a good news story to pass along. Dr. Ken Whipple and Dr. Kevin Emge, two highly-qualified anesthesiologists will begin practicing at GRMC late summer and early fall, respectively. Dr. Bojan Pavlovic, a pain management specialist, will begin practicing at GRMC within the next two months. We just recently welcomed three new physician assistants, Kristin Leonard, Sarah Feddersen, and Jarrod Phelps. We are delighted to welcome these professionals to GRMC not only for their expertise but they meet specific needs for our patients and community expectations.

We continue to recruit for a variety of physicians to fill our current needs. This includes orthopedics, internal medicine, and obstetrics/gynecology. Believe me, when I can share more good news with you, I will. And, I hope that you will help me get it on the rumor mill.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Monday, July 21, 2008

A Perfect Example

Recently, I was able to attend one of the Monday morning SE*ED programs. I spoke a little about current goings on at GRMC and had the opportunity to answer questions.

A woman asked about her Medicare statement following an x-ray procedure done at GRMC. She said the bill read that the charge for the x-ray was $125 dollars and that Medicare had paid $24 dollars. She asked if that meant that the hospital had to make up the difference in the bill. Yes, that’s exactly what has to happen.

How do we make up that difference? For our nonprofit, non-tax supported community hospital to break even we have to lower expenses and find new sources of revenue.

I am confident that we will come through this difficult time as a stronger organization. Even in the past year when we have incurred substantial losses, we strengthened our balance sheet, improved our facilities, added new technology, and cut our costs as we could.

We are in a challenging situation but at the end of the day, we continue to be here when you need us for quality healthcare close to home. And we’ll be here in the years to come.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Thursday, July 17, 2008

Reflections on 40 Years

In December 1967, a small group of dedicated community members came together to merge two hospitals, St. Francis and Community Hospitals, into Grinnell General Hospital. I understand this was not an easy task.

One of the aspects of the merger that has most intrigued me was the secret meetings held in Clinton with the Mother Superior of the Order of St. Francis. Frosty Mitchell, Al Eisenman, Frank Chrisbens, William Autrey, and Lawrence G. Keeney traveled separately to Clinton, Iowa. Frosty, Frank, and Bill, representing Community Hospital, traveled by car while Lawrence and William (Larry and Bill) flew by airplane to Clinton. They said that it would arouse much suspicion if these five men traveled together, so they decided on a different course. It almost sounds clandestine.

Those who were most involved in the day-to-day operations of the hospitals fully understood the situations they faced. It was difficult and neither organization was on solid ground. What they knew for sure was that one strong hospital would best serve the community instead of two hospitals that were dividing their resources, the physicians, and, ultimately, the community.

I have nothing but respect for these individuals who were passionate about their community and committed to providing quality healthcare. Their decisions were not always popular but made in a spirit of community betterment. It’s difficult to lead in a new direction when others aren’t quite seeing the same vision.

We have come a very long way in the past 40 years. Healthcare is changing at a blinding rate. The industry advances that have been made since I started working as a hospital administrator 25 years ago are more than I ever imagined as a student. Grinnell Regional Medical Center has grown from that solid foundation built from the experience of community leaders who love their community and want to make it stronger for everyone.

As I think about the merger of St. Francis and Community Hospitals, I am reminded of a quote by Margaret Mead who said, “Never doubt that a small, committed group of citizens can change the world. In fact it is the only thing that ever has.”

The GRMC public relations department published a book celebrating the hospital's history. You may purchase the book at

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Tuesday, July 15, 2008

Why Advocacy Matters

Early on in my career, I realized that it was worth the effort to build relationships with our elected officials. I’ve been honored to go to Washington, D.C., with the Pow-I80 delegation several times. It gives us an opportunity to talk directly to our Congressmen about issues that affect our county and even our region.

Since 1994, I’ve been working with our Congressional delegation to change the Medicare reimbursement rules that put hospitals like GRMC at a distinct disadvantage. GRMC board members, staff, and community supporters have traveled with me to Washington, D.C., to share our message.

In a nutshell, GRMC is paid less than what it costs us to provide services to patients who rely on Medicare for their insurance. GRMC is too large to be a Critical Access Hospital and too small for a Rural Referral Hospital. There are seven hospitals in Iowa who fall into this “tweener” category with us including Burlington, Carroll, Ft. Dodge, Keokuk, Muscatine, Newton, Spencer, and Spirit Lake.

Senators Grassley and Harkin and Rep. Boswell and their staff members have been working with us to amend the Medicare reimbursement rules to remove this unfair payment system. We are actually working together to change Medicare law. Often people say that an Act of Congress is harder to work with than an Act of God. Some days, I wonder.

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Friday, July 11, 2008

The Idea Born on a Napkin

It’s been a dream of mine to create an idea designed on a napkin. A year ago, three GRMC colleagues and I were in California going through training at the Institute of HeartMath to become certified HeartMath instructors. Afterwards, we sat in a restaurant talking about this technique called HeartMath and how it could be beneficial to our patients and hospital.

The more we talked, the more we realized that HeartMath could transform more than just healthcare in our area, it could transform the entire community. I began taking notes on a napkin, trying to capture the great ideas created through this conversation. We kept coming up with ways to use HeartMath in the schools, with families, social and human service organizations, businesses, city government, law enforcement, and the list went on.

When we had finished, a project known as “The Heart of Grinnell” was born. This community-wide wellness initiative will bring together all aspects of our community to improve our health and quality of life. GRMC is joined in this project by Grinnell College, the University of Iowa College of Public Health, and the Institute of HeartMath.

The Heart of Grinnell is a five-year intervention study focusing on stress reduction through HeartMath to reduce disease and injury and to enhance health and our quality of life. It is easier and less expensive in the long term to preserve health than it is to cure illness.

Improving healthcare is an important national issue. I firmly believe that until we put the focus on keeping people healthy, our current healthcare system will simply not meet the needs of our country. In fact, our current practices may ultimately bankrupt the entire U.S. economy. Our current system is based on curing illness, not preventing it. The future of healthcare has to be about prevention and living well.

The Heart of Grinnell seeks to build a community coalition throughout Poweshiek County to include Grinnell College, schools, businesses, churches, social service agencies, local government, and law enforcement. Through this HeartMath project we will provide an intervention to not only study the effects of stress on our lives, but how well HeartMath can work to reduce this stress.

In the months to come, I’ll continue to keep you updated on this project. Right now, we are working closely with Sen. Tom Harkin for funds to begin our work. This project is included in the annual Labor, Health and Human Services budget for FY 2009. We’ll be monitoring Congressional activity on this funding and look forward to launching this project.

And to think it all started on a napkin….

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.