Today’s blog is the continuation of a conversation we started last week with Dr. Bob Trenschel, Yuma Regional Medical Center CEO. In this two part blog, Dr. Trenschel shares his thoughts on the successes, challenges and the future of healthcare in Arizona. Once you’ve had a chance to read part 2, we’d love to hear your thoughts. Generating meaningful conversations around the health issues facing us here in Arizona is another way we are working to make our state the Healthiest State in the Nation!
- When you think about the future, what are you most hopeful for?
I think it’s exciting – and daunting – that we have new entrants coming into the healthcare space such as Apple and Amazon. They are working on some big ideas. This falls into what keeps me up at night and what I’m hopeful about. The tech companies and other new entrants into healthcare are able to move more nimbly and probably without a lot of the regulatory burden we have to deal with as a hospital. They are outside of the structure, having to meet some of the requirements, but not the most onerous or cumbersome ones. My fear is that they might siphon off a lot of the high-margin business and leave healthcare with the rest of the low-margin, high-burden and highly-regulated care. I also think this provides healthcare organizations like ours a powerful reminder to continue to be more nimble, like we have with our recent Innovation Day and the all the innovation taking place throughout our organization. We need to continue to push ourselves as an organization to say ‘How can we do things better and more effectively?’
When you look at what Amazon has done for business – I don’t know that it would ever happen for healthcare – but certainly that mentality and approach could be brought to healthcare and people’s needs. When you have a cold or an infection or a rash do you always need to see a physician in person to get that prescription? People don’t want sit in the doctor’s office, especially when they aren’t feeling well. Through telemedicine, such as access on your mobile devices, there’s so much that can be done to make access to healthcare easier and more convenient for patients. That is both an opportunity and a worry. How can we be the organization that can do this for our community? I am hopeful for us at YRMC because I think we have tremendous assets at our disposal. We have great market share, great processes throughout the organization and we provide high-quality care. We have the bones to really be something unique in healthcare. Thankfully, we don’t have to worry much about new entrants coming into our market. I think we can be all the things that healthcare reform thinks it wants to be. We can do that here…without any external influences. I don’t think there are many hospitals like us in the country.
- What are the greatest health needs in your community?
Mental and behavioral health needs are major in this community. As our community’s only hospital, we must take a leadership role with this particular issue. Throughout healthcare, mental health has typically been poorly reimbursed and not always recognized as essential, so it doesn’t receive the attention it deserves. For us, this lack of care places a huge burden from an organizational perspective on our Emergency Department and ICU. People needing mental health or behavioral care come here, either on their own volition, by court order, through the police or because they were involved in some kind of trauma. These cases bog down what our organization is able to do, as we are forced to determine transfers and assure safe passage for these patients as they find their next node of care. There is such care available in Yuma, but nothing like what is needed.
In-patient behavioral health truly serves high-risk patients. I’m not sure YRMC will ever add that particular service, but it is possible. I think we need to have a place within our organization where we can treat patients and keep them for not a long period of time, but at least stabilize them and get them into community-based care. It could be an arm of the Emergency Department. This lack of services locally also places a huge burden on the families, who separated from their loved ones if that person needing help is taken to Phoenix or Tucson. This care really needs to be local. We simply need more mental health professionals. We need to recruit more providers and build a better node of mental and behavioral health within our organization. It will be a loss leader for us, but it’s something we need to do.
We are also challenged when it comes to access to primary care in Yuma, along with recruiting specialists to our community. This may always be somewhat of a challenge, but I believe it’s becoming less so. For primary care and specialists, providers are looking for organizations where they can practice with ease and not have a lot of burden that you might find at a lot of other, larger organizations or systems. You don’t have access to the people who are truly the decision makers. It’s layer upon layer of bureaucracy. If anyone thinks we have bureaucracy at YRMC, we have no bureaucracy. I have met with three physicians in the last three days. That just doesn’t happen in larger organizations. That in itself is a major selling point for our organization. During our recent Innovation Day at YRMC, we had several physicians touring and they said: ‘This is the kind of organization we want to be a part of.’