The fate of health care reform remains undecided. Discourse on the issue rages throughout the nation. One thing is clear, there are more questions than answers. Below is an op-ed that I have written on our position. It was published August 13 in the “Queens Chronicle,” a community newspaper spanning the neighborhoods of Queens. The concerns of community teaching hospitals, like ours, play a major part in the reform debate. Our President and lawmakers must consider the delicate balancing act hospitals endure to bring health care to our communities.
Stephen S. Mills, F.A.C.H.E.
by Stephen S. Mills (as appeared in Queens Chronicle, August 13, 2009)
Health care reform has a chance to positively influence access for all Americans and to streamline the process of reimbursement to health care facilities and physicians, at an affordable cost— through savings, better quality, and appropriate utilization.
President Obama is driven to accomplish this reform, something that presidents have been after for decades. Success will be measured within the reality of politics for insuring those without coverage, and with incentives to cover preventive care and care for chronic disease.
The time is right. The President is determined and that is key to making it happen. However, until there is a definitive plan and every sector of the health care army commits to sacrifice to make it a reality, reform remains undefined and unfunded.
The core issue at hand is two-fold. First, why is health care reform necessary? How will it provide value (cost vs. benefit)?
Talk about a health insurance “exchange” is amorphous. The issue of the uninsured is well known; thus a specific plan to mitigate this is essential. As time passes, unemployment wipes out family resources, including employer-provided health insurance. We have to consider the many who have health insurance— employer sponsored or individual plans. For them, not only have premiums risen at double-digit rates over the past few years, but also high deductibles and co-insurance per episode are onerous to middle class people, which results in postponing necessary care. So, what will be the plan to make these out-of-pocket expenses manageable?
Without some cap on malpractice awards and/or rudimentary reform, huge financial burdens are placed on physicians and on health care institutions that simply are not sustainable. As physicians are leaving practice; hospitals and nursing homes cannot provide the spectrum of services the community requires.
Hospitals, nursing homes, physicians, and insurance companies are plagued with over-head costs, employing masses of people to “manage” necessary insurance authorizations, process-denied hospital stays and physician visits, billing errors, coding and medical record documentation, accounts receivable and complex follow-up issues. Hundreds of millions of dollars are spent (and ever-increasing amounts will be spent) to support this bloated bureaucracy.
The President is looking to Congress to develop the plan. Amid politics and big money lobbyists, Congress needs to understand the importance of extending the right to health care to all— and the necessity of shared sacrifice in order to achieve it. The American public, including Congress itself and special interests, the private insurance companies, the pharmaceutical and hospital industries and physicians, some which have already anted-up some sizeable dollars, all need to play a part in reform that adds value.
Within the discussion of how to pay for it, we believe that taxing those citizens most able to afford it is acceptable. Increasing taxes to the middle class is not. They cannot take on more financial burden to gain and keep access to care.
Quality enhancements can and should cost less. Primary and preventive care, patient safety initiatives and accurate and timely information are just some of the enhancements that we know pay off for people and for “the system.”
In summary, a specific proposed plan, with clear, long-term funding sources is essential. The elements have to include broad coverage, incentives for U.S. industry to be able to compete in a world economy on a level playing field with international companies that do not have the uncertain and growing burden of paying for healthcare as we do in this country. Individuals with health issues are not denied coverage or dropped from the insured category. Out-of-pocket costs, not just for premiums but the onerous and growing deductibles and co- insurance dollars are mitigated and predictable. Lastly, the element of choice of plans and coverage is integral.
In order to get to the goal of true, value-based reform, all parties in the health care industry must sacrifice something to afford what should be an advantage to all. If value is not perceived, we will once again miss an opportunity. Without a specific plan, no one can buy into just a concept.
New York Hospital Queens continues to expand by adding services and highly qualified physicians and leaders who can meet the needs of our community.
||Warren D. Kroeppel, as a manager of essential public services, is a natural fit for New York Hospital Queens’ Board of Trustees. Mr. Kroeppel, general manager of LaGuardia Airport, joins the board as our 20th member. A 31-year veteran of the Port Authority of New York and New Jersey working in both LaGuardia and JFK airports, Kroeppel brings a proven management track record to New York Hospital Queens. A certified flight instructor and commercial pilot, Kroeppel received his master’s in business administration at Adelphi University.|
Over the last year, our Orthopaedics and Rehabilitation program has been restructured by new clinical chairman Jeffrey Rosen, M.D. Under his leadership, the department has sustained measurable growth and community demand has blossomed. Two new, highly specialized surgeons join the department to expand capacity and access in service of our physicians and community.
Alexander Golant, M.D., and Tony Quach, M.D., join our Department of Orthopaedics and Rehabilitation as full-time, highly specialized attending orthopaedic surgeons in sports medicine. Fluent in Russian and Chinese, respectively, these two physicians both completed residencies in orthopaedic surgery at the New York University Hospital for Joint Diseases and achieved their medical degrees from the University of Pennsylvania School of Medicine in Philadelphia.
Dr. Golant completed his sports medicine fellowship at Lenox Hill Hospital, New York, NY. Dr. Quach is fellowship trained in sports medicine from the UCLA Department of Sports Medicine.
Two physicians, both board certified in internal medicine, have joined the medical staff of our New York Hospital Queens Family Health Center in Flushing and Jackson Heights Family Health Center. Both centers serve high numbers of patients who prefer to receive care in languages other than English—in this case Chinese, Korean and Spanish.
Ezra Hangjung Jang, M.D., comes to us from Brookdale University Hospital and Medical Center in Brooklyn. He achieved his medical degree from Hanyang University College of Medicine, Seoul, South Korea, and a Ph.D. in biochemistry and chemistry from New York University. He completed his residency training at Brookdale University Hosptial and Medical Center. He is fluent in Korean.
Roger Yang, M.D., joins us from Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, in the Bronx. Dr. Jang achieved his medical degree from the State University of New York at Stony Brook. A native Queens resident, Dr. Yang is excited to return to the borough of his youth to serve our community. He is fluent in Mandarin Chinese and Spanish.
The addition of highly skilled, multilingual physicians is a major benefit for any health care institution. Bogdan Grigorescu, M.D., a surgical specialist in urogynecology, and Jian Qun (Kathy) Huang, M.D., skilled in minimally invasive techniques and robotic surgery, have joined our Department of Obstetrics and Gynecology and, between them, speak seven languages.
In cardiology we continue to strengthen our team. Marios D. Gagos, D.O., joins us as an attending physician in the cardiology division of our Department of Medicine with a special interest in nuclear cardiology. Dr. Gagos is a long-time member of the Hellenic Paneliakos Society of New York and has been very involved in the Greek-American community. In 2004, he was a volunteer medical assistant at the Olympic Games in Athens, Greece. In his new position at NYHQ, he will play an important role in promoting cardiovascular health in our local communities, specifically our growing Greek-American community. Dr. Gagos is a graduate of The State University of New York at Stony Brook, with a degree in pharmacology, and also has an MBA from New York Institute of Technology. He achieved his medical degree from the New York College of Osteopathic Medicine.
We are pleased to announce our recently appointed medical director in the Department of Medicine and assistant residency directors in Emergency Medicine.
||Magdalena Cadet, M.D., was recently named director of the division of rheumatology in the Department of Medicine. Since 2008, she has served as an attending rheumatologist at our hospital. She has re-established our osteoporosis service and cares for patients in the hospital, at our Ambulatory Care Centers in Fresh Meadows, and soon will treat patients at the new Center for Orthopaedics and Rehabilitation in Fresh Meadows. She completed her fellowship training at New York University Hospital for Joint Diseases. She conducted her internal medicine residency both at New York Hospital Queens and Yale-New Haven Hospital. Dr. Cadet achieved her medical degree from Drexel University School of Medicine in Philadelphia.|
Alison Suarez, M.D. was recently appointed assistant residency director for procedure and simulation education. Dr Suarez graduated from our hospital’s emergency medicine residency program, and plans to bring innovative programs and training modalities to our emergency medicine residents.
Manish Sharma, D.O., was recently appointed as the assistant residency director for didactic education in the Emergency Medicine Department. Dr. Sharma has extensive experience in emergency medicine medical training.
As a community teaching hospital, we share in the responsibility of educating the next generation of health care professionals—through our residency and fellowship programs, symposia, medical forums and published works.
Burton Wasserman, D.D.S., chairman of Dental and Oral Medicine, was the guest editor of a new textbook published by Dental Clinics of North America. The 240-page book, “The Special Care Patient,” features 17 chapters written by national experts in every area of special needs dental care. A text devoted to the dental care of the special needs patient was long overdue, according to Dr. Wasserman. Dental schools are making strides to incorporate special needs training into their core curricula.
Penelope Chun, M.D., director of emergency ultrasound, and Sanjey Gupta, M.D., attending emergency physician, recently moderated the research forum of the Annual Scientific Assembly of the New York Chapter of the American College of Emergency Physicians. James G. Ryan, M.D., emergency medicine residency director, and Dr. Gupta served on the research and education committees. Dr. Chun presented her research, “The Significance of the Wall Echo Shadow Triad on Ultrasonography in Emergency Room Patients,” co-authored by emergency medicine physicians Anita Singla, M.D., Anjali Bharati D.O., Nidhi Garg M.D., and Dr. Gupta.
Diabetes Research Trial Recruiting Participants
Our Theresa and Eugene M. Lang Center for Research and Education is enrolling patients in a new study of type 2 diabetes. The study, called TINSAL-T2D (Targeting Inflammation using Salsalate in Type 2 Diabetes), looks at the safety and effectiveness of an investigational medication (similar to aspirin) in the treatment of type 2 diabetes. The study medication is FDA- approved to treat arthritis, but it has not yet been approved for diabetes.
Nationally lauded endocrinologist, Daniel Lorber, M.D., associate director, Lang Center for Research and Education at New York Hospital Queens, is the principal investigator of the clinical trial. Earlier this summer, Dr. Lorber received the ADA’s “Outstanding Physician Clinician Award” for his contributions to the ongoing fight against diabetes.
For more information on the study or its criteria, contact the Lang Research Center at 718-670-2914.
Patient Safety Mondays- Multidisciplinary Leadership Rounds
Interdisciplinary problem solving is a way of life for our organization. Now we are taking this to the next level. Every Monday, a team of more than 100 members of hospital management selects a patient safety standard, makes rounds on patients units to inspect the area and reviews the topic with unit staff. What has resulted from these “Patient Safety Mondays” is that our staff are better informed about patient safety standards and our leadership is keenly aware to what degree we meet or exceed those standards.
The original model for the program was developed by NewYork-Presbyterian Hospital. The program was adapted to our needs and the formal program began here on June 1. In August, our hospital’s Accreditation Committee joined our team of more than 150 people. Supervisors, nurse managers, administrative directors, clinical chairmen, vice presidents, chief medical officer Stephen Rimar, M.D., senior vice president of nursing Michaelle Williams, R.N., and chief operating officer John Sciortino have joined me to make up the multidisciplinary rounding group.
Major Modernization Update
We remain on track to open the 190,000 square-foot (seven story) wing, now known as our “West Wing” by mid-2010. The construction plan remains on schedule. The exterior curtain wall, windows and metal panels are being installed on all floors and are scheduled for completion by mid-September. The major mechanical equipment and the emergency generators will be functional by the fall.
The cooling towers and emergency generators have been delivered and installed on the roof. The West Wing’s main roof and the second floor roof have been installed. The third floor roof is nearing completion.
||All mechanical, electrical and plumbing roughing including information technology cabling continues on all floors. An upgrade to the existing campus fire alarm system has been completed. Interior drywall is nearing completion on the 4th and 5th floor nursing units and is continuing on the 1st floor operating and recovery rooms. The radiation shielding is currently being installed where radiological examinations will be performed in the 2nd floor procedure rooms.|
There is a Heart Hosptal in Queens—Right Here at NYHQ
This is the bold message now being launched to our community.
A new marketing campaign is spreading the word to the public and physicians that every tool, technique, and technology needed to protect and restore cardiovascular health can be found right here at New York Hospital Queens. Our communications strategy includes raising awareness that there is no need to leave Queens for excellent heart care.
The advertising campaign features some of our own medical staff, and a realistic rendering of the hospital’s new West Wing that is slated to open in 2010. The ads began to roll out in mid August in newspaper, broadcast and outdoor forms of media.
As well, the campaign includes communications intended specifically for physicians; to let them know about the growth of the program, new faculty, and how to access the services they want and need for their patients.