Beaumont Hospitals to lay off 2,475, cut 450 positions
So after the CEO effectively shuttered the Wayne site last week, and it was obvious they were hemorhagging cash, I feared this was coming.
My sister is currently awaiting word on her status, but more broadly speaking this is a bad, bad sign.
April 21st, 2020 at 10:12 AM ^
"Smoking is correlated strongly to back problems as well."
I did not know that. Fascinating.
Horrible fusion rates as well
Nicotine dehydrates the disc, which leads to disc height collapse and also an increased risk of disc herniation. Both of these result in eventual pathologies that could require surgical intervention.
Nicotine also constricts blood vessels, leading to decreased blood flow to the bone that is attempting to fuse across an instrumented disc space. This results in lower quality fusion or even non-fusion after a surgery is performed.
Smoking is bad.
April 21st, 2020 at 10:47 AM ^
You're describing a situation similar to what my daughter is going thru. A few years ago she was in an horrific car accident. To be quite honest, she should've died if it weren't for the grace of the Big Guy upstairs. It happened 5 days before senoir year in high school. She couldn't walk for 3 months and missed half her senior year bed ridden. A month ago she started having serious pain in her hip. Went to the doc, had an xray and found one of her screws in her pelvic bone is working itself out. Ortho surgeon scheduled her 1st thing the following Monday. Hospital called that Sunday evening to cancel the surgery due to Covid-19. Now she has a screw working itself out and no idea if she's gonna get this resolved soon or not. Not to mention the pain she's in as well. If and when the restrictions are lifted, as a dad, I'm concerned about putting her in a hospital and taking a chance of her being infected.
April 21st, 2020 at 10:15 AM ^
I don't know anything about Beaumont's current status, but a hospital can be both overrun by COVID-19 and out of money at the same time since the rest of the hospital, and the highest revenue-generating parts in particular, will be as cleared out as possible.
That this can happen simultaneous to the greatest flux of critical care need we've ever seen is one hell of an indictment on our healthcare system
How?
Medical operations experiencing extreme duress because they can't charge 20k to repair an ACL (or whatever other elective surgery) is pretty damning of a structural problem.
(as are the ~10M newly uninsured because they lost their employment, which is a different but related issue to this one)
April 21st, 2020 at 10:56 AM ^
Do you think they shouldn't bother with ACL repairs, hip surgeries (I have a friend who is basically crippled and waiting for surgery and can't get it), that sort of thing are unnecessary and shouldn't take place in hospitals? And then, of course, the physical therapy that is associated with that. Another person I know suffered an aneurysm a couple of years ago and still needs therapy to help her walking, and that's basically out because she can't visit the hospital in person. Is that unnecessary?
These are layoffs. The workers are being laid off because of cash flow issues, but also because they're not being used. And when you cut off huge parts of your business, you lose cash flow and you wind up with employees that have no work to do.
There are arguments to be made about how hospitals do business in the context of our larger healthcare system, but this doesn't make the argument that you think it does.
April 21st, 2020 at 12:21 PM ^
My wife works for Ascension, her profession is a Mammographer. Since the closure of her office in March, she has been reassigned to the hospital to help support. One week she was on the COVID floor monitoring people who entered COVID patient rooms. The next week, she was in the laundry room helping there. Now she is working 2nd shift at the ICU floor.
This has been an interesting situation here. On the one side, she is proud to be helping out (honestly, the tasks they have her doing are far below her skill set but it helps take the stress down for the doctors and nurses).
Yet, she is terrified that she has been "forced" to go to the front lines. She has seen more deaths in the past few weeks then anyone should have to see.
She did also note that the hospital plays Rocky - Gonna Fly now every time the are able to take a patient off of a vent. Need to celebrate the recoveries to try and off set the gloom.
Not sure how much longer Ascension will keep her re-assigned, but my point is yes they have kept their skill staff employed and basically finding them something to do to help out.
April 21st, 2020 at 12:42 PM ^
I have a number of people who work in healthcare in my church, and I have 10+ years of working at hospitals under my own belt, and I've heard lots of stories like that. Unfortunately, some of these places eventually run out of extra work for people to do. Beaumont, which has had full COVID-19 utilization for weeks, was one I would have thought would have more excess work available.
The local hospitals in Duluth have been undergoing a series of layoffs for weeks, as there has not yet been a surge here but everything elective is still idled.
Granted, there is an additional factor: Some places may be in a position to decide between reducing hours for more or layoffs for fewer. Layoffs will, I believe, allow people to take unemployment, which under current conditions may be preferable financially to reduced hours for a short time. I know that's been true for a lot of people. The bus company I am associated with looked at each employee's situation in turn and basically laid off the people who would make more by hitting unemployment than staying on, while keeping on those for whom that was a better option.
" Do you think they shouldn't bother with ACL repairs, hip surgeries (I have a friend who is basically crippled and waiting for surgery and can't get it), that sort of thing are unnecessary and shouldn't take place in hospitals? "
No - I think hospitals shouldn't have their financial well being tied to elective surgeries and private employment rates.
Because it demonstrates that instead of being medicine driven our healthcare system is profit driven. Which goes a long way to explain why we spend more and get worse results than the overwhelming majority of the rest of the industrialized world.
April 21st, 2020 at 10:36 AM ^
So ... if it was medicine-driven rather than profit-driven, the orthopedic surgery personnel would be doing what, in your worldview? Watching a couple of Khan academy videos to become pop-up infectious disease specialists?
Maybe an oncologist should take one for the team and pitch in as an orderly, mopping some floors to battle the virus?
April 21st, 2020 at 11:00 AM ^
Good observation. Maybe we should have fewer orthopedists. This journal article suggests that 4-6 orthopedists per 100k population is clinically sufficient.
As of 2016, the US had 9.2 per 100k population. That's conservatively ~10,000 more than clinically necessary in one specialty. Maybe some of them should be primary care providers (who typically make less money for themselves and their employer) while supporting lower overall system costs and better population health outcomes.
To defend the status quo is directionally aligned with profit-driven medicine
Your logic doesn't make sense. Having more ortho's would bring the price down, not raise it up.
If you had say 4-6 the price would be higher.
April 21st, 2020 at 11:18 AM ^
If hospitals weren't run by corporations who's only goal is to increase stock prices you would not have staffing decisions being made for economic reasons. I'm not sure how you can argue that isn't what is happening, and has been happening for decades. The reason rural hospitals are closing is because it's cheaper for corporations to close them instead of running them at a loss.
If instead we used a system like the UK's NHS, that wouldn't happen. But we've chose for at least 40 years to purioritize the profits of multinational corporations and insurance companies over the health and well-being of actual people.
April 21st, 2020 at 12:34 PM ^
Beaumont isn't a corporation whose only goal is to increase stock prices, since it's a non-profit organization, as are more than 50% of hospitals in the United States, compared to roughly 21% that are for-profit.
That's not to say that hospital consolidation isn't a problem (it's a huge issue, at least as big among non-profits as for-profits), but when one discusses solutions it's helpful to address actual causes rather than made-up ones. You could dissolve HCA, Community Health Systems, and Tenet today and you'd still have the issue of bloating hospital conglomerates putting bricks on the pricing scales.
And the current issue really has little to do with any of it, because all healthcare utilization is steeply declining, except for that associated with COVID-19. "Elective" isn't just stuff that is made up to make cash. It's real stuff that people need that is being put off right now. It's not bringing in cash, and there's no reason to keep a full staff of dieticians at a diabetes center or ultrasonographers in a radiology unit or phlebotomists in a lab or registration staff in the lobby when they don't actually have work to do.
Where is it said that we get worse outcomes? In fact, the various numbers I have seen say that we have better five-year survival rates for most cancers than either the UK or Canada, and the same goes for things like heart attacks and ischemic strokes.
Or... You know.... The government shutting down their revenue caused this?
Is it an indictment of our restaurant industry that people are being laid off?
Nope.
This is what happens when the public is consumed by one thing - COVID death tolls and the government listens to them.
But, hey ... Whatever...can't believe how insensitive it is to talk about reopening the economy.
The stability of the healthcare system shouldn't rest on for profit procedures. Restaurants are closed right now (yes, due to government) but hospitals are literally overrun with patients, they are not lacking for "business" in any normal understanding of the word.
April 21st, 2020 at 10:36 AM ^
Unless you are living in an area with many CV patients, hospitals are not overrun at all. Even ER's that are busy with CV patients are losing money. What is happening in places like NYC and New Orleans, is not the picture in most of the country.
FWIW, the private and much of the public side of US hospital system are designed to run at or near full capacity. Anything else is a bad business decision if you are talking about the private side of healthcare, and every expensive to maintain if you are talking about public, i.e. the VA.
April 21st, 2020 at 10:57 AM ^
Exactly, they all are designed to run at near max capacity. Unused beds are expensive lost revenue and increased overhead, which makes us highly sucseptible to a pandemic overrunning the system. This is why we needed to flatten the curve.
I don't see the US healthcare system running at anything less than almost capacity, because it doesn't make sense in any situation to not run like that. Where we could fix the system, is in payment, as there is a huge amount of expense going to insurance coverages and payments and covering people that aren't covered.
April 21st, 2020 at 10:57 AM ^
Exactly, they all are designed to run at near max capacity. Unused beds are expensive lost revenue and increased overhead, which makes us highly sucseptible to a pandemic overrunning the system. This is why we needed to flatten the curve.
I don't see the US healthcare system running at anything less than almost capacity, because it doesn't make sense in any situation to not run like that. Where we could fix the system, is in payment, as there is a huge amount of expense going to insurance coverages and payments and covering people that aren't covered.
April 21st, 2020 at 10:42 AM ^
Have you been to a hospital?
Huge portions are sitting vacant. The only parts stretched to capacity were ED and ICU.
Lots of room for business.
I don't know if you realize it, but the implication of your statement is that hospitals should charge more for emergency care.
I disagree. Having elective procedures subsidize emergency care is a great system as it means everybody can get the care they need regardless of their ability to pay. The fact that hospitals are closing because the government has forced them to abandon elective procedures is a failing of the government, not the healthcare system.
The stability of the healthcare system shouldn't rest on for profit procedures.
Actually, it DEFINITELY should. If it were the other way around, the most badly-needed procedures would be self-rationed by the people needing them, and the least-needed procedures would be in too high of demand.
April 21st, 2020 at 10:09 AM ^
Jesus this is just so dumb. Its not solely about death tolls, its the ability of society to function. Sure 200k will die from Covid and our healthcare system won't be able to function leading to thousands of other preventable deaths from heart attacks, strokes, car crashes, etc. but other than that totally worth it to open up an economy that will have no international trade, no travel or tourism, and 70% of consumers who are smart enough to value their health not going to things like restaurants and the movies. Anytime you can kill hundreds of thousands of people so that the economy can shrink marginally yes you just have to do it. America, where rich people staying rich is more valuable than human life
Also go find a doctor in NYC and tell them you are willing to throw away their life because you are annoyed. I wish anyone who attended a rally this past week gets a card that lets hospitals know they don't have to treat them since dying for the economy is cool with them.
April 21st, 2020 at 10:16 AM ^
I find every outraged person who posts that circulating meme about waiving medical care 10x as fucked in the head as anybody protesting (militia excluded).
April 21st, 2020 at 10:28 AM ^
If you want to take your life into your own hands that is on you but going out now puts other lives at risk. When a nurse or grocery store worker dies because of one of those dumbasses they should know its their fault.
Putting someone else's life on the line because you are an incredibly stupid person isn't something that should be encouraged.
April 21st, 2020 at 10:51 AM ^
I love how every outdoor activity is akin to spitting in someone's mouth. Not to mention wipes and hand sanitizer exist. It's just not feasible to stay at home much longer.
Young and healthy people dying are the exception, not the rule. If you are at risk and immunocompromised or live with someone who is, stay home like you've been doing once these orders start to get phased out (which is already underway). Or is that not dramatic enough for you? Go on with your daily ad hominem bullshit.
April 21st, 2020 at 12:02 PM ^
Young and healthy people are the ones most likely to spread the disease. Maybe have a little empathy for the person you might kill. You have no idea what you are talking about, literally every public health expert says easing up restrictions will lead to more deaths. A survey of UChicago economists, a known conservative economics program, found 100% agreement that opening the economy back up to thousands of preventable deaths is worse for the economy than smart social distancing. Nobody who is actually intelligent or studies these issues is arguing to open things up. Its just a few rich corporate owners who won't be at risk themselves and thousands of dumb lemmings going to the protests.
April 21st, 2020 at 12:21 PM ^
You didn't even acknowledge most of my argument. I said we can probably prevent deaths while still being outside, getting the world turning again and taking precautions while protecting. Just because young people spread the virus among themselves doesn't mean any of them are sentenced to death. Meanwhile you just spew more of the same "stay at home forever, take this seriously" tropes.
How is someone working at a restaurant part time consistently going to kill an at risk person at home?
April 21st, 2020 at 12:21 PM ^
Shit turds.
April 21st, 2020 at 12:34 PM ^
Where was all of this concern for the 3,000,000 people who died in the US last year?
Why didn't anyone care enough to shut down the country for them?
April 21st, 2020 at 12:39 PM ^
I'm a little skeptical of 100% agreement on anything. I'm extremely skeptical of 100% agreement about statistical projections of the future. The only way they could reach unanimity is by suppressing divergent opinions, either intentionally or otherwise.
April 21st, 2020 at 10:58 AM ^
This is America, where everyone is free to express their own opinion, as long as it is the opinion approved by the self-appointed "elites." Anyone who dares to hold an unapproved opinion is obviously worthless and beneath contempt, and therefore they deserve whatever misery they get.
The approved opinion two months ago was that this virus was not dangerous and that anyone who thought otherwise was probably racist. The current approved opinion is that this virus is an existential threat, the likes of which have never been seen before, and which is therefore worth plunging the economy into chaos and putting 22 million Americans, and counting, out of work.
Please, try to keep up with the approved opinion in the future.
April 21st, 2020 at 11:27 AM ^
Those who advocate for people to be denied health care because they want to exercise their 1st amendment rights should perhaps volunteer give up any unemployment benefits when they lose their job.
April 21st, 2020 at 12:06 PM ^
1st amendment rights don't trump public safety and public health. Its something the Supreme Court has found on numerous occasions. You can say whatever you want online but crowding together during a pandemic is a public health issue
April 21st, 2020 at 12:31 PM ^
Civil liberties are being trumped left and right these days.
April 21st, 2020 at 12:47 PM ^
Yes, yes they do. That's why neo-Nazis are allowed to march. They are clearly a risk to public safety yet they can march anyway. The exception that is carved out is for immediate dangers to public safety (the "fire in a crowded theater" exception.)
Neo-nazis can't just randomly march any where they want whenever they want. They have to get permits and stick to where it was cleared for them to protest. Also while being a neo-nazi is being a terrible person they are not in that instant a direct threat to someone. The first amendment protects their right to have that belief system. Being a virus carrier makes you a direct threat to someone. Its not in any way equivalent. There is a reason someone who intentionally coughed on a grocery worker was arrested and charged with assault
Being a virus carrier makes you a direct threat to someone.
I doubt anyone would be protesting an order to quarantine people who are actually sick. My problem is with the paranoid assumption that everyone is infected.
To the extent anyone has to get a permit, it applies to everyone; you can't require some groups to get permits and not others. And it's not always true; sometimes you can just march where and whenever. And when permits are required, the burden is on the government to show its requirements don't infringe on free speech, which means that yes, free speech trumps public safety.
I don't think anyone's saying coughing on someone is free speech. That's not applicable here. But if being a virus carrier is dangerous enough to restrict someone's rights, I remind you that even though flu is less deadly, it still can be deadly; yet we have (fortunately) never suggested that flu season requires us all to quarantine.
April 21st, 2020 at 10:12 AM ^
Give it a rest.
In case you hadn’t noticed, we’ve dropped from 3rd nationally to 6th, and almost 7th, since the at home orders were announced.
But, yeah, let’s paint Whitmer as the baddie for taking actions that have clearly saved lives.
It’s not her fault our for profit hospital system is so fucked up that it was designed to fail if we ever had a situation exactly like the one that we are right now.
She cut off the leg to save a couple toes.
You can definitely blame her. That was her choice.
In case you haven’t noticed, Peter, places like Disney World and all the major sports leagues shut down of their own accord, not because they were ordered to. They sacrificed billions because what they heard and saw made them realize that the risk wasn’t worth it.
So you can stop it with this “the gubmint made everyone shut down” chicken you’ve been fucking so excitedly for a whole month now.
April 21st, 2020 at 10:16 AM ^
Hospitals have shuttered all of their elective and routine surgery. Everything from kidney stones to Neurosurgery. Surgeons are sitting at home. Basic public healthcare is on hold due to Covid preparedness. 95% of hospitals are getting minimal Covid hits.
Hospitals are bleeding because they are not designed to run on one stop shopping. They are very intricate service businesses. Most hospitals have tried to reassign their employees. Cardiac Rehab for example has been shut down. Those patients are getting called at home but their level of rehab is suffering. The rehab therapists have been reassigned to work ICU Covid rooms or provide environmental disinfectant services.
At some point we could break our system. Many hospitals are expecting a serious influx of business from the backlog when we open up.
April 21st, 2020 at 10:00 AM ^
This is largely because of the near complete cancellation of non essential or non emergent clinic visits and procedures. I only participated in maybe 4 procedures over the last two weeks for cancer patients which would normally be 5-6 x that.
The ER, the most active part of hospitals these days, largely loses money.
April 21st, 2020 at 10:04 AM ^
I get that. I understand why Beaumont is cutting staff based on how hospitals make money and which procedures are financially incentivized.
I'm saying that's a terrible paradigm.