Medicine in Montgomery
Prescription for Prosperity
The health-care industry is an economic driver and key employer for Montgomery and the River Region. Major players explain how they are dealing with challenges, outline what the future may hold and highlight the region’s many opportunities.
- High Tech Right Here
- Regional Medical Campus a Game Changer
- Nursing Education Options
If You Build it?
We have the hospitals and clinics; we have plenty of patients who require care. But do we have the necessary contingent of doctors and nurses to meet their needs? For now, yes. But soon, maybe not. That’s the consensus from hospital administrators, nursing and medical school instructors and others in the know on the subject. “For our population and service areas, we have enough facilities with Baptist Hospital, Jackson Hospital and some outside clinics,” said Julia Henig, Vice President of Business Development at Baptist Health. “The issue we face, like all industries, is the aging population of baby boomers. We don’t have enough professionals coming in behind those who are retiring to fill their shoes, and that means we don’t have enough medical professionals to take care of all the aging, and our retiring doctors and nurses are adding to those ranks.”
According to Henig, the number of doctors we need, but don’t have, could hit 90,000 across the country in the coming years. And it’s the same with nurses and gets worse when you look at medical specialties. Some new and interesting solutions, supported by advances in technology, are being considered to combat this workforce shortage, things like telemedicine and an increased reliance on “mid-levels,” people like nurse practitioners and physician assistants, who in the future may be trained to do more. “We’ll have to figure out something or people may have to drive long distances for a specialist and even for primary care,” Henig said.
Feeling the Void
While the most obvious fix is to get and keep more doctors here, that’s easier said than done. “Doctors in training will have about 100 opportunities offered to them before they are done, so it’s very competitive to get them,” Henig said. Recruitment is a large part of her job.
One issue making it difficult is the fact that our Medicare reimbursement rate is lower than other parts of the country. But, as Peter Frohmader, Marketing Director at Jackson Hospital pointed out, we have some positives that other areas can’t match. “All the providers in the community are working hard to recruit doctors,” he said. “We continue to be very successful once we get potential doctors here. They are very impressed with our city, what has been happening downtown, in economic development and our resources for a city our size.” In the last few years, Jackson has recruited more than 50 health- care professionals.
Henig agreed. “Our community?is where we shine,” she said.?“We are a big small town, a great place to raise a family, with proximity to lots of great places. We don’t have bad traffic, and we’ve got a regional airport.” She also pointed to another benefit. “We have the fantastic opportunity to start a specialty medical career,” she said. “We are not oversaturated with specialists.”
And she praised the Chamber for its help. “It is often easier?to recruit families over single people,” she said. “We some- times work through the Chamber to help get a spouse placed in a job, and they have been great in that effort.”
High Tech Right Here
Providing world-class care here at home so residents don’t have to leave the market is a priority for both of Montgomery’s hospitals and that means staying up to date with the latest and greatest medical technology and coming up with new ways to serve patients are necessities. Here’s a brief overview of a few recent advancements at both Jackson and Baptist.
The 3-Tesla MRI: the strongest MRI used on patients anywhere (and currently the only one here). It gives doc- tors the ability to see things they’ve never been able to before.
Tru-D SmartUVC: a germ- eliminating robot that generates UV light energy that modifies the DNA or RNA structure of an infectious cell. Jackson is the first hospital in the River Region to use it.
The Davinci X5 Robot: the newest tech for robotics in the country, being used to perform minimally invasive surgeries.
The UAB Multi-Specialty Clinic: staffed with 10 doctors in four specialties with breast and cardiovascular surgery added in summer 2017.
So you find out your surgeon did his training in the back of an 18-wheeler. Sound sketchy? Don’t worry. It’s not. One key piece of the medical professional retention puzzle is making continuing education a no-brainer. Of course, this pays off for patients too. At Jackson, surgical teams often train in a mobile lab, which just happens to be in an 18-wheeler’s trailer. Stryker, a medical equipment company, drives its lab (basically a surgical suite on wheels) to the hospital and sets up shop and then brings entire surgical teams in to get specialized training on cutting-edge equipment. This particular mobile lab is for neurosurgery and spine procedures using 3D navigation, a kind of GPS mapping and imaging for your body, that Jackson now utilizes.
UAB Med School Good for MGM
UAB’s School of Medicine Montgomery Regional Medical Campus started in 2012 and?is in partnership with Baptist Health. “UAB knew the med school needed to increase its class sizes and produce more doctors for our state,” said Dr. Wick Many, regional dean for the school. But rather than have those students assigned to the main campus or UAB’s campuses in Huntsville or Tuscaloosa, the recommendation was to place a campus in Montgomery.
The idea was that UAB’s close relationship with Baptist Health would remove some of the difficulty of starting a new program. But the focal point was the lack of access to care in some of the economically depressed areas right outside of Montgomery. “The hope is, if we train doctors here and have them live here, that the long-term investment will pay off by having many of them come back and work here,” Many said.
Dr. Many and others work hard to make the med students’ time here a positive experience, and they’re getting help. “The city, the Chamber and Baptist have bent over backwards to help us,” he said. “I am in awe of the support we receive and the welcome the students are given.”
Area doctors are pitching in too. “Our faculty is mostly voluntary,” Many said.
The students, who are all in their third year of medical school when they come to Montgomery, love it. “They go back and brag to students in Birmingham about the relationships they are developing here,” Many said. And these relationships could make all the difference when the students are deciding where to settle in the future. “Will all our students come back to this area? No.?But if we have 20 graduate and have three to five come back, that is a homerun, and I think we will get that,” Many said.
And it’s a win-win, according to Many. “The students bring a level of excitement and enthusiasm that rekindles those feelings in our faculty who are practicing doctors,” he said. “It raises the level of educational discourse, gets them talking about new breakthroughs. The students are actually bringing some new ideas and knowledge to these faculty, things that just weren’t on the map when some of our faculty were in school.”
Making Montgomery Home
Julia Henig, Vice President of Business Development at Baptist Health, stressed the role residents can play in recruiting doctors. “To get doctors here, we need to continue to add to and improve upon existing amenities and entertainment options that make quality of life great,” she said. “And to keep them here, we need to embrace them."
One recent?recruit to?the area explained why?he came and?why he and his family feel so at home. Dr. Geoff Habermacher, a urologist, came to Montgomery last year from Charlottesville, Va. He’s now practicing at the UAB Multi-Specialty Clinic. “To be successful, and to be on the leading edge of a new venture for a large academic center like UAB is a neat thing,” he said.
He and his family are also enjoying the welcome. “Both of our daughters are fitting in well. Plus, the people are as warm as the weather, and that’s nice.”
Affordable Care Act Uncertainty
Adding to the problems plaguing health care everywhere is uncertainty over the Affordable Care Act and its replacement. “The overall state of health care in general is really an unknown with the uncertainty at the federal level right now,” Frohmader said. In a perfect world, more people insured is always better for hospitals and health-care providers. “Better access is a great premise, but under the ACA, we still had problems with payment,” Henig said. “Many were still uninsured and those insured at the lowest level had such high deductibles. Some reform is needed for sure.”
Tapping into Talent
How the River Region is fighting an impending nursing shortage head on.
Our area – just like our country – is already facing a nursing short-?age as well as a nursing faculty shortage, a situation Dr. Jean Leuner, the Dean of the College of Nursing & Health Sciences at Auburn University at Montgomery (AUM) calls “the perfect storm.” “We are seeing baby boomers retiring; as they age, we see the shortage intensifying because the need for more nurses is getting greater,” she said. “There’s plenty of interest in nursing, but we have more qualified applicants than we have seats in schools.”
A look at data from the Bureau of Labor Statistics shows that we had 2.71 million nurses in 2012 and that figure will rise to 3.24 million by 2022, an increase of 19 percent. And yet, we still fall short. “It’s estimated that we’ll need an additional half million nurses by 2022, so the growth we have is not enough,” Leuner said.
One factor that you’d think might make the situation even more dire, hasn’t. “The work of nursing has gotten more complex as our population ages and the number of chronic diseases has increased,” Leuner said. “It is a very demanding profession today, but we still have many who want to do it.”
Yet, we don’t have the manpower to train them all. The faculty short- age is, as Leuner put it, “severe.” Adding additional instructors to nursing schools is one reason recent recommendations put out by the Institute of Medicine call for doubling the number of nurses who get a doctorate degree so they can, and hopefully will, teach.
There’s also a need for more nurses with bachelor’s degrees, and in an effort to meet that, AUM has put its RN to BSN program completely online, which lets registered nurses pursue a bachelor’s, and is admitting new students to it every semester. The school has also created a community for pre-nursing students, blocking off an entire floor in a dorm for them to live and learn together. “It’s the first academic community like this at AUM, and there is a lot of research showing how beneficial these live/learn groups are,” Leuner said.
Both Montgomery hospitals are doing their part. Jackson now has a nurse residency program that leads new RN graduates through a yearlong training program. “They are practicing nurses but continue their training while working, and work with a dedicated experienced nurse who serves as a mentor for them,” said Peter Frohmader, Marketing Director at Jackson Hospital. Jackson also offers an externship for nursing students in their last two semesters of school. They operate as nursing techs, and get paid while they finish their studies. “We hope they stay on with us once they graduate and pass the nursing exam,” Frohmader said. “Both programs have been very successful and great transition tools for new graduates who maybe don’t feel confident to just step out on their own.”
Kay Bennett, Vice President of Human Resources at Baptist Health echoed both Frohmader and Leuner. “There is a great demand for nursing, not just here, or regionally, it is nationwide,” she said. “We have a lot of strategies, but one?is working closely with area schools, like AUM as well as Troy and Wallace. With AUM, this relationship is more formal; we talk to their nursing faculty often and get their feel for what is going on and how we can help their efforts.” Baptist offers nurse extern programs where students actually shadow nurses in eight different departments, rotating every week, to get an idea of where they’d like to work.
The hospital also facilitates a support program for just-graduated nurses where they meet monthly to talk, share advice and more. “Our senior leaders participate in that, and we get feedback from the nurses and make adjustments to make their work environment better,” Bennett said. “These are ways we not only recruit but also retain good nurses.”
And retention is key. “We have and are looking to implement a lot of strategies on this point,” Bennett said. One is establishing unit councils?in every department to provide their nurses the ability to make decisions that affect their day-to- day. Another is recognizing and rewarding good work with awards. And finally, giving nurses flexibility and the chance to grow is key. “We have a place for a nurse to practice in almost every area,” Bennett said. “We’ve also increased the number of clinical educators on the floor sup- porting our nurses. And going forward, we’re looking at some pretty creative shift scheduling and different staffing models all in an attempt to understand what nurses need to be successful and meeting those needs so they can best care for their patients.”
According to Leuner, 90 to 95 percent of the graduating nursing students from AUM stay in the greater Montgomery area, so it behooves both hospitals to keep an eye on these students and reach out to them.
Leuner and her team are being proactive too, working with local health-care entities to see what AUM can do to best meet their needs in terms of nursing, things like revising or adding to its curriculum. “This means our graduates are better prepared to onboard quickly at local hospitals and health-care agencies,” she said. In the end, this is all good news for nursing students and middle or high school students interested in the career. “The employment opportunities for nursing students are great,” Leuner said. “When our students graduate, they have job offers in hand, and that is due to the huge need. Especially for bachelor’s degree nurses, the employment outlook is amazing.”
Nursing School in the River Region
For River Region residents looking to enter the nursing profession, there are several options for education right here at home. Here are some of the offerings.
TROY UNIVERSITY MONTGOMERY:
• Associate of Science degree in nursing, a two-year program that allows its graduates to take the national licensure exam to become a licensed registered nurse.
• Master of Science in nursing
• Bachelor of Science degree in nursing
• RN to BSN?
• Master of Science in nursing with specialization in Family Nurse Practitioner
AUBURN UNIVERSITY?AT MONTGOMERY:?
• Bachelor of Science in nursing?
• RN to BSN, which allows registered nurses to obtain their BS degree in nursing, and is offered as a totally online option or in a hybrid?format with partnership hospitals.
• Master of Science in nursing