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Public Radio Broadcast Features Lutheran HealthCare
WNYC Radio featured Lutheran HealthCare as a positive example of what is working amidst Brooklyn's health care struggles.
Told to Reinvent Themselves, Brooklyn Hospitals Continue to Struggle
WNYC Radio/July 29, 2013
Brooklyn is close to losing two large and historic hospitals despite the efforts of community activists, elected officials, and blue-ribbon panels to keep them open. A mix of economics, politics and long-term health care trends has been shuttering hospitals around the region for decades and could claim more Brooklyn institutions in the years ahead. WNYC's Fred Mogul reports on some of the evolving ways providers are treating patients.
Fred Mogul: Ann Marie Nicolette is in the neurological rehab center in Lutheran Hospital grating cheese to serve over macaroni and meatballs.
Ann Marie Nicolette: I'm sorry couldn't make my own tomato sauce.
Fred Mogul: She had a minor stroke, came to Lutheran for emergency treatment and was transferred to intensive inpatient rehab. She's been here for about three weeks now, most of that working to regain muscle control and restore basic skills of daily living, like, grating cheese.
Ann Marie Nicolette: This cheese is pretty good, usually I don't grate cheese at home. I buy it already grated.
Fred Mogul: Neurologist Dr. Salman Azhar says this is great physical therapy and just the sort of task they'll incorporate into the regimen they'll send Nicolette home with soon.
Dr. Salman Azhar: I want you to come up with a set of things that you enjoy, it may be cooking it may be doing something different, that allows you to start using your hands more.
Fred Mogul: Lutheran works hard to get to patients like Nicolette early to limit the damage from strokes, and the hospital also works hard to retain them through the inpatient and outpatient recovery, which typically last a year or longer. Dr. Azhar says keeping people in Lutheran's network in the Sunset Park area of Brooklyn is crucial for improving treatment.
Dr. Salman Azhar: We need to think about not just that one episode which is the acute stroke but we have to think about what happens for the whole year.
Fred Mogul: And he says keeping patients, especially the high complexity relatively profitable patients like stoke victims, in Lutheran's network is crucial for the financial health of the hospital which is one of the only ones in Brooklyn to break even. Mostly, experts say, the borough's health care systems fails to meet the needs of both its rich and poor communities. People with financial means often go to Manhattan for high end medical care, while everyone else relies on old debt-burdened hospitals for often substandard care. Jim Tallon says basic economics of long challenged hospitals in many Brooklyn neighborhoods.
Jim Tallon: If a hospital is serving a low-income community, it probably has a fair number of patients who are not paying – they are uninsured – so, left on its own, a hospital serving a low-income community is going to be financially in distress.
Fred Mogul: Tallon, the president of the United Hospital Fund,
says in order for hospitals to better serve marginal communities and deal with chronic health problems like asthma, diabetes and heart disease, and remain financially viable, they'll need to change how and where they treat patients, they'll need to provide care in less costly settings, in primary care clinics, in rehab centers and at home.
Jim Tallon: These are the things that are going to lead to the high quality care and the cost efficiencies that we're going to see throughout a changing health care system.
Fred Mogul: Much of this is already happening at Lutheran, the hospital has created its own network of neighborhood clinics. At one of them, on a recent day, Dr. Angela Ng examined little Vincent Tan. He was born a month ago at the main hospital a few blocks away. Nurse supervisor Susan Li says this clinic treats everyone from newborns to the elderly and works closely with the hospital when special services such as mammograms are needed.
Susan Li: For example the patient, if today had a 2 o'clock appointment for a mammogram, we don't need to go to the hospital or get a document faxed to us, we would rather go to the electronic medical record to see it.
Fred Mogul: A state panel appointed two years ago by Governor Cuomo to come up with solutions for Brooklyn praised Lutheran for the range of care it offers in various settings. Elsewhere in the borough the panel found a mismatch between health needs and service providers. The final report said Brooklyn had more hospitals than it needed, but said the weakest ones could still survive and play a valuable role if they joined forces and consolidated their services. But merger talks never came to anything. Panel chair Stephen Berger says that's because none of the hospitals wanted to make concessions.
Stephen Berger: And nobody wants to deal with it because everybody has to change and people are rather hanging on by their finger nails.
Fred Mogul: Two institutions, Interfaith and Long Island College Hospital, are on the brink of closure. As recently as 2010 between them they discharged 26,000 patients. The state which owns LICH says it would like sell the Cobble Hill complex to a health care system to run as a much smaller facility. That's happened in other parts of the city, but it remains to be seen if Brooklyn will get any takers. For WNYC, I'm Fred Mogul.
The abbreviated story and a link to the full audio can also be accessed online on the WNYC website by clicking here.
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