Where I Stand — Guest Columnist Bill Welch: Facing challenges

Friday, Aug. 27, 2004 | 8:58 a.m.

Editor's note: In August the Where I Stand column is turned over to guest writers. Today's columnist is Bill Welch, president of the Nevada Hospital Association.

MOST INDIVIDUALS spend little time thinking about hospitals until their services are needed, at which point we then expect that all modern technologies will be readily available to serve us at a moment's notice. It is also interesting that hospital care, a service which would be considered a privilege in many countries -- particularly when we consider how hospital services are subsidized -- is looked upon as a "right" in ours by so many people.

Meeting the public's expectations can be astronomically challenging. Hospitals are one of the most heavily regulated health care providers in the country.

There are laws to tell us who we must treat, how we must treat them, when we must treat them, where we must treat them and how much we can charge. Furthermore, hospitals are the only component of the health care community required to provide service to any individual who enters a hospital emergency room for service, whether or not their medical condition is considered an emergency.

As the uninsured/underinsured sectors of society grow, hospital emergency rooms are now looked upon as providers of both primary and emergency care.

While hospital reimbursement is being controlled more and more through various regulatory mechanisms, our costs to provide care continue to grow. For example, we have seen double-digit or sometimes even triple-digit increases in our cost for blood supplies, pharmaceuticals, technology advancements, medical malpractice insurance, etc., and we are forecast to see little to no relief in these areas in the years to come.

While a focused effort has been put forth to deal with the shortage of licensed health care professionals, we are years from educating the qualified staff we need today, a problem further exacerbated as the Baby Boomer generation reaches an age at which the demand for health care services is high. In fact, I believe this alone may become one of Nevada's major public health care issues, as the demand for health care services grows faster than we can produce the work force and the access to basic and emergent service becomes restricted.

There is a litany of other issues I could discuss -- medical malpractice issues, Medicaid reimbursement, bio-terrorism preparedness and the rapid growth of Nevada's citizens who require mental health services -- but I want to demonstrate here that there are many challenges which hospitals encounter in our efforts to ensure the citizens and visitors of the state of Nevada have access to quality, safe, hospital-based health care services when they are needed.

I am proud of the accomplishments Nevada's hospitals have made in working toward this goal. Modern, up-to-date hospitals have been and are being built to meet increasing patient demand. Existing hospitals are expanding and updating their technology.

Many resources have been committed to help educate, recruit and retain the health care professionals needed to staff our hospitals' various departments. Hospitals are proactively working with regulatory and other oversight committees on ways to improve the delivery of safe and quality health care services.

Hospitals are also providing health fairs and community education to pro-actively improve the quality of life of the citizens within our communities.

It is vitally important to note that while these challenges are great, they are not insurmountable, and our commitment to meet the needs of our citizens and tourist population is as strong as ever. In any situation involving human intervention, mistakes or misunderstanding will occur; however, we are constantly working to eliminate such barriers to provide the best possible experience for our patients.

The hospital system, from start to finish, is a complex machine which requires the cooperation and collaboration of many entities to ensure that the wheels continue to turn and that our patients' needs are met. In this spirit, the public experiences the "tip of the iceberg," which is supported by a massive body hidden beneath the surface keeping it afloat.