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Health Talk 

When Ochsner Health System recently announced it was purchasing three Tenet hospitals -- Meadowcrest, Kenner Regional and Memorial Medical Center -- the institution brightened the outlook for health care in the New Orleans metro area. Tenet's pullout at first seemed to signal another nail in the coffin for New Orleans' economic recovery, so Ochsner's purchase is seen as a local company's renewed confidence in the area. Ochsner hopes to boost the number of services available, including specialties, and increase hospital beds available to residents.

Dr. Patrick Quinlan, chief executive officer at Ochsner, talks about that institution's future and New Orleans' recovering health-care system.

Q: Tenet has decided to pull most of its resources from the metro area, but Ochsner has decided to increase its holdings. What's the difference between your outlook for this area and Tenet's?

A: Our focus and purpose is different. We're a not-for-profit; we're homegrown and started in 1940. This is our home -- we have no other options or interests. The future of the city is our own future. We need our major institutions to do their jobs, and even new jobs if we're going to get where we need to be as a community. We have a local knowledge and local focus that national Tenet doesn't. We know the people, we know the need. We just got done with a series of meetings with Meadowcrest's management, and there's an awful lot of optimism and dedication, with some clear ideas [about] what can be done to improve those facilities and make it better for patients. I think when you have a corporate focus or a national focus, you go more for a homogenous approach rather than a generational approach, which is what happens when you're part of the community.

Q: With Charity remaining closed, how will this purchase combat the shortage of care for the indigent?

A: People need a place to go. Remember, part of recovery is timing. University Hospital is recovering, and it's supposed to open sometime this fall. I think that's about 200 beds. These hospitals that we're acquiring are at less than 50 percent capacity (due to staffing shortages) right now and have been for quite some time. So if we can add another 150 beds, given the number of doctors available and demand, and you add that with those 200 beds, then you're talking about a material difference. When people think about health care, they usually think just about hospital beds, but hospitals provide a significant number of outpatient services that's part of the medical picture. Then there are a large number of physicians for whom the availability of those hospital beds, the hospitals themselves and the way they work together, is a critical part of the ambulatory service available for the city. So many of these pieces are interdependent; you fix one and the others can get better.

Q: Your current hospital is considered a "closed" system, where doctors are Ochsner employees and generally only their patients can be admitted. These three new Ochsner hospitals are open to all doctors and any patients with any kind of insurance, including Medicaid and Medicare. How does this make a difference for Ochsner and the New Orleans population?

A: The closed-staff nature of this hospital (Ochsner New Orleans) is a product of history. We anticipate this will continue this way in the main campus. However, if you look at our Baton Rouge facility and our new Raceland facility, those were open and will stay open. [As for the three hospitals we're acquiring], we are dedicated to preserving and enhancing the way they are currently operating. Our goal isn't to populate them with Ochsner doctors; our goal is to populate them with community physicians. We earn their loyalty by how well we provide services for them and their patients. We'll be able to accept Medicaid and Medicare in these facilities, and if we're able to have the right level of service and the right level of capacity, then we'll have a payor mix that should sustain them.

Q: How much were repopulation figures factored into your decision?

A: The specific figures weren't in a sense of, did we do a tight analysis of repopulation before we made the decision? Population is one thing, but what about what's our best sense of medical demand? We know from looking at and talking to our colleagues in the other hospitals that they are full. And we're at the low end of the spectrum right now in terms of disease. Summers tend to be a lull, and we were lucky last winter that there wasn't an outbreak of respiratory disease. I don't think you plan on being lucky two years in a row.

Q: Memorial Medical Center remains closed. What are its prospects?

A: We endorse the current work to restore the New Orleans Surgery and Heart Institute, which is the surgical part of Memorial and is supposed to open in mid-September. We have met with the restoration committee, a group of physicians and administrators working hard to bring that campus back up, and we asked them to sit down with us and plot the future so we don't get locked in to a plan for rebuilding that may impede its further growth. Given Ochsner's local focus and capacity, we want to make sure we're sizing it right and planning for growth. I think that the campus has a bright future.

Q: Are you focusing on recruiting former residents -- doctors and nurses -- back to the city?

A: Absolutely. That's your best bet. They know the place, they love it, and they won't leave. Q: Have the recent arrests of two nurses and a doctor at Memorial for their actions during Katrina's aftermath forever tarnished the hospital's reputation? A: I think we all need to suspend judgment. Tarnishing assumes that something bad is concluded. We don't know enough to say that. I think this rush to judgment is a disservice to everybody. I'll tell you from having been involved in this Katrina experience -- I was in my office for seven weeks -- if you weren't there, you don't know. There's an abyss that you're going to have to jump over to start making assumptions and drawing conclusions from what happened there. It's fine to raise the question; it's a mistake to then come up with an answer until all the facts are laid out, and they're clearly not laid out yet.

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