Public not comfortable with health care system

By RON LARSEN

Journal Staff Writer

NEW ULM -- Even with all the technological advances, such as tele-medicine, new surgical procedures and drugs, coming on-line every day, Allina Health Systems' chief operating officer, David Strand, told Rotarians Tuesday "there is still a sense in the community that health care is not where it should be."

Physicians and nurses are feeling disenfranchised from the system, and, worse yet, "the way we pay for health care in this country has separated the consumer -- the patient -- from the process," Strand said.

In particular, Strand said, "there is a strong feeling among nurses that they aren't able to do what they came into nursing to do, and we must bring the physician-patient relationship back into center circle. We must address these issues."

The problem is that for sometime the employer has been the customer, Strand explained, and the consumer was left out.

"But that's changing. Now, with the Internet, the patient has access to all sorts of medical information," Strand said. "I'm not saying everyone should be diagnosing themselves -- that's dangerous -- but they certainly can become more knowledgeable about what needs to be done."

Strand noted in the past, religious organizations played an important part in health care, but now health care is moving away from those values. Efforts in Washington to protect patients' rights and stimulate reform in the health care system are further evidence the public is not comfortable with the state of health care in this country, Strand said.

However, the big question, according to Strand, is what should health care look like. He believes there are five steps that the health care industry needs to make in order to restructure health care or government will eventually step in to restructure it.

"First and foremost, we need to put the patient back in the center," he explained. "Then, working with our physician community to put the physician-patient relationship back in the center is going to be important, with emphasis on patient safety.

"Third, we need to talk about how we use all this new technology in delivering health care to communities like New Ulm, and we need to talk about how to allocate limited health care assets. It's really up to you (the community) how they should be allocated. Finally, we need to really focus on prevention and maintenance of health care."

Expanding on this list, Strand said health care providers need to determine "how do we care for those with chronic diseases, mental health illnesses and end-of-life care, as well as moving people through the system."

He said Allina learned in working with inner-city consumers that health care is connected to economic levels. He said Allina discovered that when economic issues are attacked and solved in low-income areas, that the state of inhabitants' health improved.

In answer to a question, Strand said the health care industry nationwide is facing a shortage of about 125,000 nurses; but in regard to Allina, it is experiencing a slight shortage in some specialist areas but with nurses it's more a matter of how many hours can they work.

Strand also said that Allina has had a sharing of operating revenues among its affiliates, but that he is working to have up to 90 percent of operating revenues stay in the community in which it is generated.

New Ulm Medical Center Administrator Brian Kief added that NUMC is far from one of Allina's most profitable properties. "In fact, we're close to the bottom, but we made a dramatic improvement this past year and we're hoping that will continue."