Louisiana’s physicians are complaining about “the lack of detail and preparation” as LSU embarks on budget cuts that affect training programs for the state’s future physicians.
“We have created another tsunami or Hurricane Katrina-type condition in regard to graduate medical education in the state,” said Dr. Andy Blalock, the Louisiana State Medical Society president.
Blalock warned Monday that the state’s “best and brightest” current and future medical students and physicians in training would leave or not come at all amid the tumult.
LSU medical school statistics show that 70 percent of those who do their physician training in Louisiana continue to practice in the state. Each physician practice means $2 million to the state’s economy, Blalock said.
The 7,000-member state medical society is getting calls on a daily basis from physicians and a lot of “concerned” physicians in training and medical students, said Blalock, who as a Lafayette nephrologist specializes in kidney care.
The LSU system of 10 public hospitals is under Jindal administration orders to cut nearly $330 million as a result of a congressionally mandated reduction in federal Medicaid support coming to the state.
LSU’s approach to solving the financial problem is to move more care of the poor and uninsured, as well as more physician training, to private hospitals in what has been called a “health care redesign.”
Physician training is called graduate medical education.
While hospital bed and service cutbacks have been announced, arrangements have not been finalized with private sector hospitals to take on the physicians in training and medical students who would be displaced.
Commissioner of Administration Kristy Nichols said Monday it would be irresponsible not to take action now to address the sudden and unexpected federal funding drop.
“We will be aggressive and responsible at the same time and do something that is truly transformational as far as medical education,” Nichols said.
Blalock said the medical society held an emergency meeting of its board last week to discuss changes LSU is implementing and the impact on graduate medical education as well as care for the uninsured. LSU officials were invited, he said, but no one showed up.
LSU system President William Jenkins and Executive Vice President Frank Opelka said Monday they were unaware of the invitation.
Opelka, who is leading the health care restructuring, said the concerns are coming from “a small number of physicians in the state.”
“We are more than happy to meet with them,” Opelka said. “We think we have a really good plan for going into public-private partnerships ... that expands the graduate medical education experience. Change is difficult for everybody.”
Jenkins said he received a letter outlining medical society concerns to which he responded.
“I told them ... that we were equally concerned and trying to address the issue,” Jenkins said.
LSU health officials revealed last week a previously undisclosed potential $83 million hole in LSU’s medical schools budget as a result of hospital service cuts and downsizing.
The budgets of LSU medical schools in New Orleans and Shreveport rely on revenues generated from their relationships with the hospitals where hands-on training with faculty physician oversight occurs.
The $83 million shortfall “demonstrates that this time line is incredibly aggressive and our concern is it’s ultimately dangerous to GME,” Blalock said. “We need to be fully transparent and vet these so we don’t do permanent damage to the high quality medical education being offered.”
On Monday, Opelka said the $83 million number is overstated.
Opelka said the $53 million figure for the New Orleans medical school, which has relationships with LSU hospitals in south Louisiana, will be mitigated depending on how quickly contracts can be ironed out for GME activities at private hospitals. He said lost revenues are expected during a three year phase-in.
The $30 million figure associated with the three north Louisiana hospitals represents all funds flowing from the hospital operations to the medical school, Opelka said. He said the hospital cutback plan should have little impact there.
Nichols said the administration will dip into medical school reserve funds and coordinate with the private hospitals getting the medical education programs “to maximize financial arrangements.”
She said the administration would “mitigate losses” by considering all means of health care financing.
LSU has announced $150 million in cuts in its seven south Louisiana hospitals including reductions in inpatient, surgical, intensive care and emergency room beds as well as elimination of some services.
In its three hospitals in north Louisiana, another $60.9 million in budget cuts are being covered either by service reductions or one-time revenues.