A New Perspective

by Arkansas Business Editors  on Monday, Aug. 10, 1998 12:00 am  

The typical hospital experience that most of us have endured involves being a patient or visiting relatives and friends. We enter the facility with blinders on and focus on the status of the patient.

As a participant in the St. Vincent Infirmary Medical Center Business Intern Program, I enjoyed a fascinating behind-the-scenes look at health care. It was a refreshing change from examining only the financial numbers behind a hospital, the health care competition and insurance issues that tend to dominate our thoughts in the business community.

Seeing dozens of health care professionals at work reminded me of the single most troubling aspect of managed health care: the way insurance companies want to tell physicians how to practice medicine. It would be worth a premium insurance price to me just to know that capable physicians who I trust could act in my best interest without consulting with a lay person reading from a computer screen.

Allow me to explain what I saw at St. Vincent.

Dr. Michael Bauer performed what he described as a routine triple bypass heart procedure without complications. Watching intently from the head of the operating table, I thought it was nothing short of dazzling.

Bauer and his six-person surgical staff were a model of teamwork — effectively communicating, concentrating, perfecting their skills, being attentive to detail, working efficiently and implementing constructive criticism. They made the most complex "routine" I've ever witnessed look effortless, yet seeing a heart and two lungs stopped and started again was a sobering reminder of the magnitude of the situation.

I couldn't help but calculate the expenses I saw during the surgery: highly skilled labor, high-tech equipment and instruments, sterilization precautions, materials like tubing that must be discarded after a single use. I also couldn't see anything I'd want them to do without.

Making Rounds

Surgery was the most glamorous part of the day, but just the beginning. Some other observations and information gleaned from the experience:

• Dr. Lynn Davis conducted heart catheterization procedures and then made rounds through the intensive care unit, which doesn't have the intense atmosphere I expected, but certainly lends itself to constant patient monitoring.

• Both in the cath lab and in the nuclear medicine and radiology departments, the technology was mind-boggling. Seeing this equipment and its value in diagnosis efforts helps explain rising costs in health care.

• St. Vincent has the only Positron Emission Tomography (PET) Scan equipment in Arkansas and is one of just 70 hospitals with the technology in the country. Dr. Jerry Prather showed several examples of how a PET Scan detects tumors and problems that other devices don't identify. PET still isn't widely used because Medicare won't reimburse for the procedure.

• The Renal Dialysis Unit, led by Evelyn Howard, probably builds the strongest relationships between St. Vincent personnel and patients, who spend about 15 hours a week at the unit due to kidney failure.

• The clinical laboratory is producing an average of 20,000 lab results on 2,000 patients a day, with business from within the hospital and from physicians clinics. Automated blood analyzers have increased productivity while cutting lab personnel needs in half. Carroll Bell and Dr. John Brineman explain that the future of lab work is in more automation with robotics as well as more blood tests that can be conducted at the bedside with a single drop of blood.

• Administrators at St. Vincent were still glowing from recent developments, including the ground-breaking for a new hospital in Sherwood and with its managed care partner, QualChoice of Arkansas Inc., winning the state employees health insurance contract, valued at $200 million-$250 million.

• There were a few floors of empty beds, indicative of increased competition and fewer hospital stays.

In general, I saw an upbeat group of medical professionals in a cutting-edge work environment. Diana Hueter, the hospital's chief executive officer, appears to have successfully guided the integration of St. Vincent and Doctors Hospital while positioning the organization to continue as one of the foremost players in the Arkansas health care market.



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