Beth Alston
The Americus Times-Recorder
AMERICUS —
Joel Wernick, CEO of Phoebe Health Systems (PHS), addressed the Americus Kiwanis Club recently.
Wernick gave an overview of PHS and its impact on the region. Here are some highlights.
On Phoebe Putney’s emerging involvement with medical education —
“If I leave you with one thought: The board of directors of Phoebe Health System spends a lot of its time living in the future. These are people who make themselves aware of what’s going on and they’re trying to anticipate trends ... one of those trends is the belief that there will be a significant under supply of physicians, especially in smaller, more rural parts of our country.”
On the Phoebe Putney’s beginnings —
“The hallmark of the success of our institution goes all the way back to its founding. Judge Putney made that check out to a small group of concerned women who wanted to improve the quality of life for the citizens of their community. And that’s how the hospital (Phoebe Putney Memorial Hospital in Albany) came into being. He had a few requests, but to give someone $25,000 in 1911, you could probably get whatever you ask for ... The mission of that institution was put in place by Judge Putney, who history tells us was a fairly benevolent carpet bagger from Massachusetts who came to the South and brought some of his broader views of the world with him, including the fact that the doors of Phoebe Putney needed to be open to all people regardless of their personal circumstances. One of the reasons we’re involved in Americus is that we have very common missions and visions of taking care of folks who have a need regardless of their personal circumstances.”
Of the board members —
“We have a number of board members, all serving without being paid, who provide their leadership and time. Throughout our system, there are 70 community leaders.
“The hospital health business is not without its complexities. Our board members serve for five-year terms. We choose not to have term limits because if someone decides they want to be a hospital board member and they roll up their sleeves and learn more about our business, we don’t want to let go of them because it takes about five years just to kind of understand the abbreviations in our business, let alone a lot of things going with it.”
On how the corporate system is set up —
“The underlying ownership of Phoebe Putney Hospital is actually the Albany-Dougherty Hospital Authority, founded back in the early ’40s; it was the very first hospital authority in the state of Georgia.
“In 1990, the authority chose to lease all the assets to Phoebe Putney Memorial Hospital Inc., a new not for profit corporation. It is the parent company that can encompass a network of other entities ...
“The hospital authority in Americus leases the assets to Phoebe Sumter Medical Center, which is part of Phoebe Putney Health System.
“Ultimately there will be no one from Albany on the local board.”
Why the reorganization?
“The hospital laws make it difficult for us to own property and do business beyond the Dougherty County line. We knew there was a lot of competition and a lot of growth, so we reorganized like a lot of other hospitals in the state have done. ... We blossomed into providing services to people all throughout Southwest Georgia. That would not have been possible if we hadn’t reorganized. There are some people out there who probably have a competitive position with us that believe Phoebe Putney and kudzu are taking over South Georgia. ... That’s just not true. Kudzu dies back in the winter and we just kind of keep on growing.
“Phoebe Putney hospital is not just a Dougherty County hospital. Only about 45 percent of the patients at that hospital come from Dougherty County.”
On the need for growth —
“ ... There are a lot of people leaving South Georgia to go to Atlanta, Columbus, Macon, wherever (for health care). We want to make the services are available here so they can choose to stay close to their homes, close to their families and get that care here. The biggest percentage of why we have grown has really been at the expense of Atlanta and other faraway cities and to the benefit of people being able to stay right here in Southwest Georgia.
“We operate several facilities ... the most recent member of that family is in Americus. We are having conversations with other communities around South Georgia ... A lot of them have contacted us because they’ve heard about the things we’re doing here in Americus and are eager to potentially be a part of that.”
On the new Americus facility under construction —
“ ... People asked why we moved the hospital site all the way across town ... We need enough property to provide for growth. We have 200 odd acres here and are going to deed 40 acres directly to the hospital authority of Americus and Sumter County.
“There are people who believe that the intersection of Highways 19 and 280 is going to be one of the hottest spots in South Georgia ... for development, with the intermodal facility and Highway 27 being divided, a lot of things. I think Americus ... is situated geographically very, very well. From a leadership standpoint, this community has been blessed with a lot of great leadership. We bought some land that will be right in the middle of a great traffic pattern and have plenty of room to expand.”
Wernick said Phoebe Putney recently opened a clinic in Pelham and also has clinics in other locations.
So where is the growth and why does Phoebe Putney need to be involved?
“One of the Albany board members ... is plant manager (of a major industry) in Camilla which produces Chicken McNuggets. Our friends in Thomasville built a new medical clinic a rock’s throw from that plant. Their plan was to provide patient care and get people to come to Thomasville ... Part of what we’re trying to do, as we invest throughout Southwest Georgia, is that if something can be provided in the local community, we’d like to be in a position to encourage people to come to Albany for those services.”
On workforce growth —
“In 1988, Phoebe had about 1,500 employees and we now have over 4,000. A part of that is in physician practices ... employed directly by our health system. Within a year, year and half, our payroll will be over $200 million annually.
“With economic impact comes economic development responsibility. You’re going to see Phoebe Putney virtually at the table no matter when economic development is being discussed. We want to be involved and we know that health care in any community is an important part of any economic growth. Not only do we create economic prosperity by the jobs that we create, we’re also a building block for other people to come and invest and make more jobs also. “Nobody believes health care is inexpensive and I agree with you but Phoebe Putney’s role is to try to keep our piece of that puzzle as low as possible.” He said over the past five or six years, Phoebe’s costs have risen an average of about 3 percent which is commensurate with the cost of living. “Some years we’ve had no increases; others we’ve had more but our goal to keep it right about the cost of living or less.”
On growth strategy —
Wernick said that the new hospital construction project going on in Americus now has economic impact. “The people responsible for it know that we have strong commitment, that in any circumstance possible, we try to use local contractors followed by regional contractors followed by Georgia contractors and then anybody else. We’re trying to keep that health care construction dollar in the state working here locally. It doesn’t always appear to be that way, but if we have a qualified bidder we certainly want to get them to the table and we have used multiple opportunities to encourage people to bid on our business.”
Wernick said the Phoebe Putney Health System continues to invest in communities.
“As a system we reinvest somewhere between $35 million and $50 million every year back into our accumulated institutions here and there. Here in Americus that will be a $125 million investment.”
On physician growth —
“There is a growing phenomenon ... In this day and age with the complexity of the economics of health care, especially younger physicians do not want to be confused or bothered with the complexity of the business side of health care. They just want to take care of patients. From that perspective, we’ve been in a position to respond and take care of the business end of it so they can take care of patients.”
What does Phoebe Putney do with its money?
“We invest in the best diagnostic and therapeutic equipment around. Our goal is that if a physician has a need for a piece of technology that we’re never in a position to have to say no ... When someone comes to South Georgia we want them to say ‘I’m using facilities and equipment that are equal to or better than I trained.’ That’s part of the attraction to get them here.” He said Phoebe Putney recently acquired robotic surgery technology. “Not only is that good for patient outcomes, but ... there are some folks who’re doing their surgical training on robots and they are not going to go to a community that doesn’t have robots available ... We have done about 10 robotic procedures ... we want to accumulate a track record so we can say how many cases we done. (Robotics is a physician manipulating a mechanical arm for a procedure.) Urologists use it for prostate cancer surgery. Half the procedures have been gynecological procedures for ovary removal, hysterectomies, etc. We believe that it will ultimately be used for heart surgery also. Nothing below the gnat line had this technology until Phoebe Putney acquired it.”
On the subject of indigent care —
“Indigent care is just one of the things we do to earn our tax-exempt status but on an annual basis, we provide well in excess of $20 million throughout our system in free care. That’s stated at cost. If you looked at it from a charge to charge basis, it would be twice that amount. Community benefits come in a lot of different ways.”
Why is Phoebe Putney not a trauma center?
“In fact we are a trauma center. If you were to count up the number of diagnoses that would be credited as being a trauma case, we do roughly about 5 to 6 percent of the true trauma cases that occur in the state of Georgia. But it is true we’re not part of the trauma system. The reason ... is that we’ve not been convinced there truly is a system. It’s a system wanting to be made. For example: we’re one of the six regional peri-natal centers where we have high-risk mothers and high-risk babies. We cover a 30-county region ... although the funding’s not great, all the hospitals in the peri-natal system work together so if one can’t take care of a patient, another one’s ready to take the patient ... We joined a system.
“In the case of trauma, there’s no real system to join. At the risk of getting political ... there is going to be a constitutional amendment offered on the ballot this fall that will call for $10 out of any license tag to be set aside specifically for a trauma system development and/or trauma care.
“One of the things we pride ourselves on is to do things as far away from the hospital as possible so we can make the greatest impact. Usually when someone makes it to the hospital one way or the other, they have developed a sickness or a problem that has grown and grown and grown until they have finally said ‘I’ve got to go to the hospital.’ On the other hand if we can do things a long way from the hospital we can improve their chance of outcome.”
He offered an example of their technology concerning the “golden hour” after onset of a heart attack. “ ... We have provided technology to regional first responders technology and put EKG reads on the vehicles which automatically send data back to the heart center at Phoebe Putney to give guidance and direct drugs to be given so people are starting to get treatment on an interventional basis as opposed to just picking people up and rushing them to the hospital as fast as possible. The care of Phoebe Putney extends all the way out to the side of the road or in someone’s home.”
On the OB issue —
“You people are part of this debate because that was a suit filed here and also in Albany about whether or not HCA Palmyra Park Hospital should be allowed to deliver babies. This debate has raged every year since I’ve been in Albany, Ga. If you do the census count there is very little population growth on Southwest Georgia. When you look at the statistics of this area and ask if there is enough growth to justify the need for an additional OB unit, statistically speaking, and the answers comes back to the same thing: there is no need. There’s plenty of capacity and anything you might do that takes away from the existing capacity has the potential to do nothing but a create a negative impact. I realize that choice is a great American motivator and fair is another ... but it’s very difficult to put your arms around what’s fair and what’s a choice ... When it comes down to the baby’s health, from our perspective we’ve invested an incredible amount of money to make sure that the obstetrical experience here in Southwest Georgia is second to none and that it’s as safe as any place you might want to be. Phoebe was in a position, at time of tornado, to accept patients in peri-natal system and to give privileges to local obstetricians and nurse-midwives to deliver babies from the Americus community at Phoebe.
“Two judges have agreed with Phoebe and they’re prepared to take it to another level but the babies will be the winners.”
Wernick wrapped his presentation with information on a recently opened, new residential hospice facility in Albany with about half the cost having come from private donations from the community.
