Calling his predecessor’s views about training doctors “old world,” the new LSU health chief said Monday the university plans to expand programs that send “residents” to private hospitals and clinics to continue their training.
“For a while now we have been moving some of our resident training programs out to our partners in the private sector,” said Dr. Frank Opelka, LSU executive vice president for health care and medical education redesign. “They’re learning across disciplines and specialties together, and across care settings not just tied to a hospital.”
Opelka called a telephone news conference in response to comments made by Dr. Fred Cerise, the man he replaced in August.
“Dr. Cerise has a view,” Opelka said. “His view is not LSU’s, per se. As I look at where we are going, I think we are moving in a positive direction from a previous old world view, which I think he stated rather well.”
Cerise voiced concern during a Sept. 20 forum that plans being discussed could negatively affect LSU medical training.
Cerise said at the time: “If you move 10 residents to this hospital, 20 residents to that hospital, you’re not going to have those same considerations at each hospital. You won’t have the same infrastructure support as you’re going to have at a larger facility.”
A wide variety of specialists and technology often isn’t available in some facilities as would be in a larger medical education facility, he said.
Residents are doctors who recently graduated from medical school, received their medical degrees, and to become fully licensed, need to train from three to seven years under the supervision of seasoned physicians. LSU medical schools in New Orleans and Shreveport support about 800 residents, according the Office of Graduate Medical Education.
“We’re not planning on moving residents across the state in small numbers to various facilities,” Opelka said.
But LSU is looking at privately owned hospitals and clinics, where some training already is being conducted, and looking to expand those relationships by sending more faculty and residents, Opelka said. “But we’re not considering that this is an expansion of the programs in multiple doses around the state,” he said.
Opelka argued that once hospitals were the center of care. A patient would be treated by physicians from the department of surgery and the department of medicine, he said.
“Now, it is a clinical collaborative that is focused on the patient and their condition,” Opelka said, adding that most care is now delivered in clinics and other settings. The outcomes are better, cost less and make the patients more comfortable, he said.
“In the old world view of pegging graduate medical education to the hospital was the right place to be. But as the patients have moved in another continuum of care, we’ve got to move the physicians and the training of all of our allied personnel in health care, to follow those patients across those settings,” Opelka said.
Cerise’s duties were reassigned after Jindal administration officials, along with the LSU Board of Supervisors, the majority of whom were selected by the governor, discussed how to reduce the budget of LSU’s 10 public hospitals by about $320 million. Changes to federal rules pushed by the U.S. Congress caused a change in the amount of money the federal government pays for its portion of Medicaid, the state and federal insurance program for the poor. The decrease in the federal rate required state government to pay more.
To compensate, the LSU Board of Supervisors ordered 34.5 percent cuts that don’t close hospitals or emergency rooms. LSU leaders also are looking at the possibility of public-private arrangements to run public facilities.
Opelka said that analysis should be ready for public review during the first week of October.