A doctor-owned hospital: New hospital in south GF
January 4, 2012 at 4:34 pm in Grand Forks Herald
For-profit hospital to open in FebruaryThe interior of the new Doctors Hospital in Grand Forks resembles an upscale hotel with plenty of natural light, stone and wood accents, floor-to-ceiling rich-hued tile, Jacuzzi tubs and noise-suppressing carpeting. Continue Reading
The stupidest thing here is that the Herald left a “talk about this” link on the article, so all the Altru supporters can come here and say what they want.
Go PHS.
Hot debate. What do you think?
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Sorry,cbeck. We have more class and professionalism to talk bad about PHS.
Hot debate. What do you think?
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Physician owned hospitals have a horrible track record as far as staying in business. There success rate is roughly 20% on a good day. That said, I wish them the best. Being a one hospital town has handicapped the people of GF more than they realize.
Competition breeds innovation. Monopolies breed complacency and contempt for the customer.
The management team at Altru is comprised of some of the best people I have ever had the pleasure to work with. They truly care about the community and the quality of care they provide.
However, since their is no meaningful competition for over 70 miles, the organization’s resistance to change is legendary (a well discussed ND trait). While Altru has led the way in adopting computerized medical records, their employee relations resemble something out of the 1970s. If given their druthers, many in administration would prefer the nurses to be female, in white pant suits, and wearing caps.
Did you know that Altru employees do not receive time and a half for holidays? They get an additional bonus ($3 an hour when I was there). Now that healthcare providers have another choice, I am sure that and several other idiosyncrasies brought about by the lack of competition will change.
The Bible teaches that Iron Sharpens Iron. Altru is a good corporation run by good people who are truly invested in the community they serve. A little sharpening is never fun, but always necessary.
In my mind this could be the best thing that ever happened to Altru. It will be better because of it.
Well-loved. Like or Dislike:
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Have to agree that competition is a good thing for the patient. We had one kid in Bismarck (two major hospitals) and one in Altru. The Bismarck hospital room was very large and well appointed (well at least like a nice hotel room) with a queen sized bed for the Mother and the Father, a sleeper sofa for other family members, a whirlpool bath, etc. In Altru, we just had a regular hospital room, no comparison at all.
Well-loved. Like or Dislike:
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I’m sorry you had that experience. You should see those birthing rooms now. They have been newly updated and are the nicest birthing rooms in the state IMO.
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I birthed three children at Altru in the last 9 years. I found the facilities and staff to be absolutely excellent. Call me crazy but whirlpool tubs and plush beds and furniture are not necessities for giving birth. Who has to pay for those things? The same people who complain about the costs of their medical bills!! We need to keep health care costs down…not increase them with luxury accomodations!!
Hot debate. What do you think?
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Admittedly have not been to Altru birthing area in over 13 years. So not aware of improvements. As for cost, cost was established by what BCBS paid 13 years ago, Altru and Bismarck Hospitals were all getting roughly the same agreed upon amount for a “normal” no complications birth.
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@lindylu Well, just remember back when Aurora was trying to get a tax exemption. An Altru employee came on here and joked that she was going to try to open up a strip club, and asked if she should she get tax exemption too? Apparently Altru agreed with her, because she was named employee of the year. That was the most tacky thing I’ve ever heard of in this city.
Hot debate. What do you think?
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cbeck: Altru doesn’t give out employee of the year awards. Don’t post something you know nothing about. I’ll keep the rest of my opinions about PHS and Doctors Hospital to myself.
Hot debate. What do you think?
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Altru is not a patient-oriented hospital. It is a consumer-driven hospital, where healthcare is a product to be bought and sold. The patients do not drive the care. Why? One reason is because the doctors have no competition among each other. Since there is a shortage of doctors at Altru (mostly specialists), doctors don’t have to try as hard because they still end up with the same patients and get paid the same. Hospitals that are patient-oriented hire an overabundance of doctors that work very hard and compete with each other so the patients get to choose which doctors they want to see instead of being stuck with someone. Patients choose this based on recommendations from other doctors, the experiences of friends and family, etc. This is one of the disadvantages of living in a small town. Altru puts profits before patients, and this is one reason why. I’m not saying every doctor at Altru takes it easy because they don’t have much competition, but many do.
Well-loved. Like or Dislike:
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Brandon: Philosophically you are correct. I will not comment on your specifics. The physicians I worked with at Altru were top notch and cared for their patients. That said, as I explained above, I am all for competition; it makes everyone better.
You will not find that level of competition in GF or Fargo because there does not exist the patient base to make living here profitable for a large number of specialists. Your assertion that healthcare is a business is correct. As a country we spend twice as much on healthcare as we do on defense. Healthcare is a BIG business, with an exceptionally powerful lobby. One need look no further than any attempt, by any administration to reform it to see how strong the healthcare lobby is.
If you are a specialist, lets say a cardiologist, you spent 4 years in undergraduate, 4 years in medical school, and another 4+6 years in residency and fellowship. By the time you are finally able to support your family without loans, you have amassed anywhere from $150,000 – $200,000 worth of loans and a burning desire to not be broke.
Unfortunately, your expenses are just beginning. If you want to “buy out” a retiring physician in an established practice you are talking about another $250,000 – $1 million. If you start from scratch, you are just like any other business owner and will accumulate several hundred thousand dollars worth of start up costs and spend the next five to ten years growing your business.
If these numbers sound unrealistic, they are actually on the low side of the scale. The point is after all that work and expense, you want pay back. That does not happen in a town of 50,000 – 100,000 people.
ND largest problem is attracting physicians. That is why the medical school is so vital. It tries to take only ND kids, hoping they will stay. It is also the reason there are mostly Family Practice doctors in the state; that is the only type of residency other than surgeon that we offer. Any other specialist has to leave, and we know from experience they rarely come back.
I remember handling a complaint from a crotchety old farmer that was demanding an “American” doctor, and “a white one.” I laughed and encouraged him to get in his car and drive to either MNPLS or perhaps Omaha.
Despite the blatant racism, this old coot had determined, incorrectly that a foreign born doctor was inferior (most Altru physicians have completed residency in the US, regardless of their country of origin).
As you said, healthcare is a business and the fact that we are able to attract physicians at all is a minor miracle. If you took a map of ND and put a pin where a physician had an office, you would find large swaths, where there are no healthcare providers at all. Unfortunately that is the price you pay for living in a rural state. There simply is not the economy of scale to attract enough providers.
Hot debate. What do you think?
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That is the point exactly. There is no difference. This gentleman’s generation allowed him to verbalize certain thoughts and prejudices that would not be tolerated today.
Like any other profession, I have worked with wonderful physicians and real dogs. There is no correlation between race and competence.
I have spent most of the last decade at a large academic medical center. We are talking Nobel Laureats in the hallway. I have worked with physicians who were Rhodes Scholars and those who were in the bottom 1/3 of their class. They hail from every race, color, creed, religion and socio-economic background (Hajib – traditional Muslim headscarfs worn by women and Seik turbans are so common no one even notices). In the end they are all the same; some just catch on a little quicker than others.
Where a physician went to school is not nearly as important as where they did their residency and what they learned while there. Med school gives you the basics, it is during residency where you learn how to apply it.
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I was in the ICU at Altru and spent my nights wide awake listening to the nurses on duty talk about their private lives. A few days later when I got a room on a floor they brought me a roommate at a quarter to eleven at night. I don’t want to go back there. I’m more than willing to go to this new hospital. We already go to the Aurora Clinic and love it there. It’s going to be nice to have another option. It sure beats driving to the cities which is where we went the last time a family member needed surgery. It was quiet there to.
Well-loved. Like or Dislike:
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GF nurses are paid very competitive salaries than they otherwise would receive if Altru didn’t have to compete with out of state hospitals that can pay them better. Might that be part of the reason Altru employees aren’t paid time & 1/2 overtime pay.
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Spearman: you are correct, Altru nurses receive competitive salaries FOR THE REGION. They in no way compare to the Twin Cities. If this new facility is successful, nurses wages will increase. Supply and demand.
When I left the hospital to fly, I took a $10 an hour pay cut. Why? There are lots of nurses who want to fly, so the boss does not have to pay as much.
When the skills you possess are in short supply, the boss has to pay more to recruit and retain you. Many people try to put an ethical spin on what is really just a purely economic decision. It is not right or wrong, it is just the tangible manifestation of an economic principle.
If Altru wants to attract the best, they have to pay for them. On the other hand, if you are a nurse and you want to work in GF (not drive 70 miles) there is only one game in town. A little mixing it up will be good for both sides.
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When you compare salaries in Grand Forks to those in Minneapolis you should also acccount for the cost of housing and commute time/costs. It will be interesting to have this conversation in one year after people have had the experience of a private for profit hospital, both from the consumer and employee experience.
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We (my family and I) have had a wide range of experiences at Altru. They range from ok to awful. I have had 2 babies, my husand has had emergency procedures and the kids have had assorted visits. The clinic staff is awful. I don’t care to be snapped at. The staff may be competent but overall, they are rude and apatetic. For lack of space I won’t go into specifics but the ER staff might be the worst. I have finally started to go to Crookston. Clinic staff is nice, providers are competent, and the ER is top notch. Thursday we had to take my daughter to the emergency room and we were met at the door, taken to a room immediatly, seen and were out within 20 minutes. We welcome competition….for all the reasons everyone is talking about.
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Chilly,
I have worked in both for profit and not for profit. In the end there is very little difference. All hospitals are for profit. Those that do not make a profit close. When you use terms like for profit and not for profit you are referring to a line in the tax code; nothing more.
As I said, a hospital that fails to make a profit closes, just like any other business. The difference is in a not for profit hospital any excess is called “operating margin” and must be returned to the company in the form of improvements. None of the excess can be distributed to shareholders. In a for profit hospital the excess is called profit, taxed by the government, and free to be distributed however the Board of Directors desires — that means it can be distributed to shareholders.
As a nurse the only hospital I noticed a difference in was a Catholic hospital I worked at for 10 years. The feel was completely different. In the old days (15-20 years ago) Catholic hospitals had a much more family feel. I do not believe that is true anymore.
The pay in the Catholic hospital was less, but comparable to the other local hospitals, and certain subjects and procedures were strictly verboten. Other than that things were pretty much the same across the board.
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I’ve had a real problem with the “Not For Profit” status of Altru. I don’t understand how what appears to be a huge corporation can operate under a not for profit status. They sure don’t have not for profit pricing when you get the bill. When I think of not for profit I think of hospitals like the old St. Mikes run by the Catholics. How did mega corporations manage to get this same status?
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Tundra:
You need to go back to what I said above. Healthcare is the largest industry in the US; bar none. As a percentage of GDP we spend twice as much on healthcare as defense. In fact, we are spending so much on healthcare that it is threatening to bankrupt the country. We won the Cold War by forcing the old USSR to spend so much on defense their economy completely collapsed. We are doing the same to ourselves with healthcare.
Altru is far from a large corporation when it comes to healthcare. Nationally they are not even on the radar. Sanford is probably 4 times as large (at least) and they are strictly a regional player.
There are several national healthcare companies that are in the Fortune 500. In PHX where I work there is one health system that owns over half of the hospitals in town (a “town” of 3+ million people).
As for “For Profit” vs “Not For Profit” see my explanation above. There is no such thing as a not for profit hospital. It simply does not exist. Additionally, you will find very little difference in the billing between for profit, not for profit, and not for profit religious hospitals. A bill from Catholic Healthcare West (which owns 40-50 hospitals nationwide) is pretty much the same as a bill from Health One, one of the largest for profit hospital companies in the US.
Many people hate my characterizations, but they are accurate. Call up one of the nursing professor at UND and ask these same questions. They will be happy to discuss the ins and outs of healthcare administration with you, just bring a cup of coffee and be prepared to get an earful.
Don’t quote me, but I believe UND has a healthcare administration track as well; I am sure one of those professors would be happy to bend your ear as well.
The notion that hospitals are somehow different from any other business is a myth. Those that fail to make a profit go bankrupt and close. That is exactly what happened to many, many small ND hospitals and why the center of the state is devoid of providers.
The main difference between hospitals and other businesses is hospitals have to provide you service regardless of your ability to pay. If you show up to the Emergency Department, they have to see you. It is the law.
This is akin to going to the drive through at McDonald’s and they have to feed you because you are hungry. It makes absolutely no sense but that is the system this country has chosen, and it is the reason it has to change or we will go from the best healthcare system in the world to one of the worst in less than a generation.
This is not an exaggeration. It is simple economics: math. You don’t have to like the numbers, but they don’t lie.
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I understand that the Not For Profit status is basically a status that exempts a load of taxes and doesn’t really mean that they’re running bare bones minimum to provide services at an affordable cost. What I have a problem with is that the whole system is allowed to have the not for profit status when basically it’s a fairly minor part of the system that has to give care regardless if it can be afforded. It would seem that there should be a formula that would account for those loses and basically exempt that part from tax. Because it’s all the padding in the for profit part that is bleeding the consumer dry. Health care pads the bills and insurance basically plays along because it’s too costly to fight every case….That all boils down to those of us who have found our insurance premimums and detuctables going sky high through no fault of our own……And yet there’s still the fox heads who believe the hype that health care reform isn’t needed…..
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Especially when a place like Altru has basically bought up it’s competition around town up to this point. The really had a complete monoply here for a while….Nothing too not for profit about that…
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In NYC people say they wouldn’t dare go to a hospital west of the Hudson River. In Mpls. people say the same about any hospital outside the TC. I once heard a patient from Boston complain about the service at the Mayo Clinic in Rochester where she was a patient. People in Sioux Falls complain about SF hospitals. It’s all relative & based mostly on anecdotal info. People in the TC even think a hospital in the far suburbs must be inferior to the city hospitals. I once had a Mpls. dr. tell me most surgeons in the TC were butchers. Ones own experience is not a scientific survey of quality & shouldn’t count for much in terms of a judgement about a city’s hospital.
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I agree with you spearman. I have read comments on the Forum blog site in the past that were largely negative about Sanford. When I said it will be interesting to have this conversation in a year from a patient/employee perspective, it was not with positive expectations for Doctors Hospital. I expect the thumbs down to increase on that post.
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When we chose a doctor in the Twin Cities to remove my husband’s prostate we did so because of experience. The doctor in the cities had removed over 2000 while the doctor at Altru only had removed 200 or so. The doctor in the cities also worked as part of a team with six other specialists in that field. We were dealing with cancer and wanted the best we could find. We also relied on referrals from friends that had the same procedure. My husband’s brother had the same situation and had everything done at Altru. His cancer came back. So far(six months later) my husband is cancer free. It depends on the person and where they want to have the procedure done.
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Of course experience counts. The range of experience within the TC dr. pool runs from the least you would find in GF to the most experienced drs. in the country. My point is people on the east coast would balk at the same TC profiles of drs. because of their prejudice toward the unknown.
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Point taken.
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