These days, most health care administrators wear two hats — or more. It’s part of life in this field at a time when hospitals and other care providers are being forced to do more with less.
But Karen Ferroni, M.D., like all medical staff directors, wears two coats.
The first is the white lab coat she dons for work in her private practice in obstetric ultrasound. The second is the suit jacket she will wear to the countless meetings she will attend in her new role as liaison between the administration at Holyoke Medical Center and the facility’s 200 affiliated physicians.
And she assumes the role at a very challenging time for both hospitals and physicians. Indeed, hospitals are being saddled by inadequate reimbursements from public and private payers and rising amounts of uncompensated, or free, care that they must provide. Meanwhile, doctors are faced with similar reimbursement woes, as well as other pressures such as spiraling malpractice costs.
“We’ve lost a number of dedicated physicians in the past several years,” said Ferroni, noting that while some have left for other, more physician-friendly states, others have retired or phased out those portions of their practices subject to high malpractice rates.
Ferroni told The Healthcare News she will be focusing on the impacts of such issues on both a global stage — perhaps by working with other hospital administrators and advocacy groups to lobby for reform — and also on the smaller stage at HCN, where individual physicians, and thus the system itself, are affected.
“The viability of private practice is an important consideration for us at Holyoke Medical Center because the physicians who come here are private practitioners — this is not a teaching hospital,” she explained. “Our relationship with those physicians is important; they need the hospital, and we need them to bring their patients to us.
“So if practice conditions in the state become so difficult that they can no longer stay in business,” she continued, “that’s going to have a very significant impact on the hospital.”
Birth of a Notion
When asked for a job description for her new post, Ferroni said she’ll be spending some of her time “putting out fires.”
By that, she meant the day-to-day issues that arise at the hospital and involve individual physicians. These include questions — and hopefully answers — concerning programs, services, procedures in facilities such as the lab and emergency room, and personnel matters.
“This is the place where physicians know they can come and complain,” she said with a smile, adding quickly that she will be spending much more of her time engaged in long-term planning designed to enable HMC to maintain the quality of its programs and services at a time when all hospitals are being pressed to the limits of their resourcefulness — and perhaps beyond.
“The resources that once made up shortfalls are drying up, and that’s the real challenge not just for Holyoke Medical Center, but for other small hospitals,” she said. “Hospitals have gotten more creative and more streamlined, but how long that can go on I don’t know … there’s only so much you can squeeze out of your costs before you impact quality of care.”
Ferroni comes to HCN from the Family Life Center at Mercy Medical Center, where she served as medical director since the facility opened in 1995. She has spent 20 years in Western Mass. in private practice, specializing in the areas of prenatal diagnosis and obstetrical ultrasound.
Ferroni told The Healthcare News that she enjoyed helping to get the Family Life Center off the ground and expand to the point where it recorded 1,800 births last year. However, she said her role there was largely clinical in nature, and she desired a position that would provide a better balance between the examination room and the boardroom.
She was recruited by HCN administrators for the position left vacant by the death last summer of Gary Reiter, and, after several interviews, both sides determined that the fit was right.
“I was very interested in working with the administration at Mercy Medical Center, and had wanted to expand my role there and interact with the administration on planning for the hopital, but my role was primarily clinical,” she said. “I saw this position as a way to move my career in a different direction.”
Ferroni, who started Feb. 1 and was still unpacking boxes and arranging her office when she spoke with The Healthcare News, spent her first several weeks becoming more acquainted with the hospital’s physicians and the issues confronting them, as well as the system at HMC, and what she called the overall “community.”
This is ongoing process, she said, one that is vital to succeeding in that role as liaison between those providing the medical care and those managing the facility.
For the immediate future, Ferroni said she is focused on the issue of quality and how to maintain it at this challenging time for HMC, and on specific projects such as expanding the facility’s recently introduced hospitalist program.
That initiative, which involves individual physicians caring for patients exclusively in a hospital setting, is off to a solid start since it was started a year ago, and HMC is looking to add more physicians to that staff, she said.
“The hospitalist program has advantages for both the hospital and physicians in private practice,” Ferroni explained, noting that physicians don’t have to leave their offices to care for patients admitted to the hospital — a plus at a time when many rely on patient volume to counter falling reimbursements — and the medical center sees a greater continuity of care for those who have been admitted, ultimately resulting in shorter patient stays.
“Because they’re in the hospital 24 hours a day, hospitalists can more efficiently move patients through their stay,” she said. “When tests come back, they’re more rapidly reviewed, new orders written, management altered or adjusted … it’s a more efficient way of taking care of the patient.”
Recruiting any kind of specialist to the Bay State is becoming increasingly difficult, said Ferroni, who told The Healthcare News that as medical director she will play some role in the process of attracting physicians to Holyoke.
“It’s very difficult to get physicians to come to Massachusetts … it’s not a new problem, but it’s becoming a bigger problem,” she explained. “While some other states are equally unattractive, there are many, many places that offer physicians a better income than what’s available here.”
The Bottom Line
Returning to her larger stated goal of ensuring that HMC can continue to play the critical role it does in the community, Ferroni said she is intrigued by the challenge.
“My goal, simply put, is to provide leadership, in whatever form it takes,” she explained. “I want to do what I can to make sure patients get the very best care possible.”
To do that, she’ll need to wear two coats — and a number of hats as well.