The brouhaha over Jackson Health System’s decision to explore whether a management company should hire 29 physicians, 16 nurse practitioners and one physician’s assistant for emergency-room services is being couched by critics as a “backdoor” end-run to turn this community jewel into a private, for-profit enterprise.
Yet so much of what happens at Jackson already is in the hands of private companies. Medical equipment, pharmaceuticals, bandages, the cafeteria operation — all are for-profit endeavors in which health and safety rules apply.
And what of the Trauma Center? That’s run by the University of Miami, a private institution.
The bottom line, as Jackson CEO Carlos Migoya has said over and over, is providing excellent care while reducing wait times and improving efficiency. If those efficiencies also cut costs for a bloated system that has been bleeding red for years, then the choice is clear.
As it stands, Jackson has been making steady progress in moving into the black. In August it had a net surplus of $3.1 million. It has come with some pain, to be sure, as some workers were laid off or had their hours cut. But Mr. Migoya’s goal, shared by the public, is to attract more paying patients, start updating antiquated buildings and grow the hospital to hire more workers. This can’t be done willy-nilly. Every option must be explored.
On Thursday, Jackson’s board directed Mr. Migoya and the unions to come up with various scenarios to improve ER services and report back in January. That should give everybody a longer view of what’s at stake. Is the goal to save Jackson for the community or focus on a few dozen jobs?
There may be many reasons why a private management company would not be able to cut it, starting with the liability insurance required for private physicians. But other hospitals that serve the poor — go no further than Broward County’s nonprofit hospitals — outsource their ER and deliver excellent care.
It’s a red herring to say that sick people would be turned away from the ER if it were under a management company. The law applies to all caregivers, public or private. People needing care must be treated and stabilized.
The plus side to outsourcing emergency care (and maintaining the quality service and access that the Jackson board and local taxpayers demand) is that such companies have a proven track record of helping people in crisis, whether they are rape victims or were in a car crash. For patients, specialization is a plus, not a minus.
Jackson, as part of a teaching institution, has a special mission, and one that is not being met in the ER where doctors are not part of the teaching mission. That’s one more reason to explore options, including whether to contract with UM, which trains new doctors at Jackson, to run the ER.
The Jackson ER is not running as efficiently as it should, judging from productivity studies that compare Jackson to its peers. At Jackson, a physician sees on average about 1.4 ER patients per hour, but emergency doctors at other institutions see three patients in the same time span. Does that indicate waste at Jackson? Maybe. Or perhaps there are other reasons, such as the critical nature of those ER patients compared to other places.
The only way to find out is to study it, look at what other topnotch institutions are doing and make the decision based on facts not on hysterical radio spots about the evils of privatization. That’s just noise that does nothing to help those who need care.