Officials at Meharry Medical College are fighting a proposal that could eliminate inpatient hospital services at its teaching hospital. Such a move would threaten the accreditation of the 137 year old institution whose mission is to provide health care services for the underserved.
The Metropolitan Nashville Hospital Authority, which runs Nashville General Hospital at Meharry and contracts with the college for physician services, hired Atlanta-based Alvarez & Marsal Healthcare Industry Group to develop short-term recommendations to reduce the approximately $33 million subsidy the city gives the safety net hospital annually.
The report, released on September 18, outlined four options for improving operations at the hospital. Three of the options include elimination and/or reduction of inpatient services at the 150-bed hospital.
Meharry leaders say all four recommendations are unacceptable and severely diminish the quality of patient care.
“Nashville is enriched by the presence of Nashville General Hospital and like all great American cities safety net hospitals are a key part of the health care delivery system. It our strong view that the Alvarez & Marsal analysis is fundamentally flawed in its outlook, conclusions, and failure to take into account not only the needs of Meharry Medical College but of the greater Nashville community in terms of providing state-of-the-art, culturally-sensitive, indigent care, and compassionate, focused, health care,” said Dr. Wayne J. Riley, President and CEO of Meharry.
At stake are services such as Nashville General’s successful obstetrics unit which provides prenatal care and delivery services for low income mothers, and its acute care services for those who enter the hospital with severe conditions and need immediate hospitalization.
“Our obligation is not only to our students but to our patients,” said Dr. Charles Mouton, Dean of the Meharry’s School of Medicine. “Elimination of inpatient services is not a good model for patient care. Meharry treats Nashville’s most vulnerable patient population. They need and deserve a full-service hospital.”
Metro Nashville Hospital Authority is holding three community meetings to gather opinions from Nashville residents. The first meeting was held October 9 at the Madison Branch Library. The standing-room-only crowd included patients as well as Meharry students and doctors who see patients at Nashville General Hospital, as well as many people who were concerned about the fate of the Bordeaux Long-Term Care facility, which is also operated by Metro Nashville Hospital Authority as is the Knowles Home Assisted Living facility.
Sonnye Dixon, president of the Interdenominational Ministers’ Fellowship which represents 200 congregations, did not attend the meeting but said his organization is concerned for Meharry’s students.
Meharry has approximately 800 students training to become physicians, dentists, biomedical researchers and health policy experts. Each year Meharry receives more than 5,000 applications for its 105 slots for medical school. Students are selected not only based on academics but also based on their commitment to fulfill Meharry’s mission to provide medical care to the nation’s poor. The majority of Meharry graduates choose to practice in rural areas or areas where there are health provider shortages.
“My concern is the impact on Meharry and the training of the people who have dedicated their lives to providing care for the poor,” said Dixon who is also concerned about the economic impact to North Nashville. Meharry has approximately 1000 employees and an economic impact approaching $500 million per year.
Dr. Riley said there is also a bigger picture to consider. Meharry has played a leading role in diversifying America’s health care workforce for more than 100 years.
Meharry is one of the top producers of African-American biomedical researchers. Approximately 18 percent of all African-American physicians in the United States are Meharry graduates and 33 percent of African-American dentists in the United States are Meharry graduates. A 2010 study published in the Annals of Internal Medicine ranked Meharry as one of the nation’s top five producers of primary care physicians and the same study ranked Meharry second in its social mission.
Meharry is also a national leader in health disparities research and is home to the Center for Women’s Health Research and the Center for AIDS Health Disparities Research.
Dr. Riley said Meharry will propose alternative business models for sustaining the hospital. One of those models could include establishing a partnership with St. Thomas Health Services.
“The current business model for the hospital must change to prepare for the changes in health care delivery and the full implementation of the Affordable Care Act in the years ahead,” he said. “Nashville is incredibly blessed to have the number two ranked medical school and academic health science center in the social mission of American medical education and we certainly hope the citizens are aware of this tremendous national treasure, and will join forces with us and the city leadership to find a workable solution to the challenges facing Nashville General Hospital.”
