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.