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.