Louisiana Spotlight for Oct. 22, 2012

Medical plan caught up in cuts to LSU

As Gov. Bobby Jindal pushes to shrink the size of Louisiana’s public hospital system run by LSU, more than patients and hospital workers are caught up in the unknown implications of the budget slashing.

The hospital system and its network of clinics provide much of the training for future doctors and other health-care professionals. That training provides the pipeline for the bulk of the state’s doctors, so a disruption could toughen access to health care around the state for years.

Lawmakers have worried that if the Jindal administration doesn’t tread very carefully, the LSU budget cuts could jeopardize training programs’ accreditations and standards, threatening medical education in Louisiana and chasing away medical students needed to treat patients in a state that already has issues about access to health care and doctor shortages in rural areas.

LSU leaders and the governor’s health secretary, Bruce Greenstein, say they’re keeping all of that in mind and have graduate medical education at the forefront of their planning.

“We’re going to make every effort to preserve what we have in graduate medical education and in undergraduate education for all our students,” said Frank Opelka, LSU’s executive vice president for health care and medical education redesign and the university system’s point person on the cuts.

The national Accreditation Council for Graduate Medical Education sent an email to LSU Health Sciences Center officials reminding them any redesign of training programs requires the accreditation council’s oversight, according to The Advocate, which obtained the email. The council asked for an update, saying LSU hadn’t provided enough information so far, according to the newspaper.

Millions of dollars in cuts have hit the 10 LSU hospitals around the state that care for the poor and uninsured, along with their extensive network of clinics. Dozens of inpatient beds, clinic services and health-care programs are being closed.

Those beds and services are used to help train new doctors.

The budget-slashing comes after Jindal chose to levy most of a federal Medicaid financing reduction on the university-run public hospital system. The governor wants to shift much of the care to private companies, calling the safety net health system run by LSU an outdated and unsustainable model for patient care.

Opelka told the LSU Board of Supervisors that 43 percent of the university’s medical student residents are assigned to hospitals and health-care facilities outside of the public health-care system.

Opelka’s predecessor, Fred Cerise, said he’s concerned about the proposal, suggesting it’s a simplistic view to assume the graduate medical education programs can just be spread out around the state. Cerise was ousted from his leadership role after clashing with the Jindal administration.

Opelka has suggested Cerise’s views and the safety net hospital model he promoted need transformation, along with graduate medical education.

But those formal arrangements with private health-care facilities have yet to be reached, threatening care for the uninsured while leaving medical students wondering where their training programs may go and how they may be restructured.

“Why are we doing this before we have these partnership agreements in place?” asked Rep. John Bel Edwards, D-Amite.

That’s a question that the accrediting agencies, medical students and patients waiting for care likely are asking, too.

Melinda Deslatte covers Louisiana politics for The Associated Press.