Dear Editor,
The cancer center went broke. I nearly did. Others in health care are adapting as they can to survive here. A national health care crisis is amplified by our island chain’s uniqueness.
I saw the city commission’s concerns about our recent, progressive “physician deficit” and service challenges directed to our hospital’s chief executive officer last month. I would like to give my own perspective as a long term Keys health care worker.
Absolutely, Lower Keys Medical Center has 4 out of 5 stars for quality and performance as rated by Medicare. The much larger Mount Sinai of South Florida has only 3 stars. Baptist Miami ties Lower Keys at 4 stars. All three are quality institutions, with their communities feeling that each has one star too many. We are not alone there. I share links to sources below.
Our community has an advantage rarely discussed. Our community is very small. Health care personnel often know their patients before the person needs care. It’s a very personal bond to be there for a neighbor in need. This has been a powerful tool for leadership to drive our quality scores up. I would like to share my perspective as a health care worker in the Keys who has been an elected, unpaid chief of staff of Lower Keys Medical Center during the pandemic, and why I had to evolve my practice or leave Key West. To be clear: I speak for myself, only.
Housing prices are the greatest challenge in keeping and recruiting talented personnel in all walks of Keys life. Lower Keys Medical Center leadership started at 1 quality star years ago and has brought our hospital to 4 stars. Blaming the leadership in our workforce crisis would be ridiculous. Hospital leaders are our primary talent recruiters. We live in the most expensive county housing market in the state. Our workforce needs affordable homes.
Locals caring for locals has been our workforce reality. What business is not complaining about our thinning workforce? Many in our workforce have been leaving to financially survive, they have told me. This is an old story, some say. But it is an undeniable market shaper now. Plus, health care needs a workforce with educational certificates in specific areas. A committed workforce that stands the watch no matter pandemic or storm, to be specific.
Recruiting is the challenge leadership faces. It is a difficult job anywhere. It can cost tens of thousands of dollars recruiting each nurse. Physicians do cost significantly more to recruit than nurses on average. It takes a war chest to fund recruiting, which can take months under good conditions. Several candidates might come to visit the site before committing.
Health care workers are more burnt out after the pandemic than at any time I can remember. It’s a national problem that frustrates pandemic deniers and recognizers alike. Burnout and denial are poor confidence companions. Solo physician practices are few now.
How many of our local physicians, full or part time, now work for some type of corporate medical group to make ends meet? Can you count the number of independent primary care physicians here in 2019 compared to now? One physician who left told me I was crazy to stay. Take the profit from my home and run, he advised. He said he could not afford to buy into our area now, if he was not selling out. Even I had to evolve to stay here. Giving away hundreds of visits over the pandemic, then this workforce/housing crisis saw me lose so much money, I had to take money from my retirement and home.
Housing is our fundamental challenge, always. Burnout and finance are what they are. Recruiting is all the much harder because of it, is my experience. Our recruiter should not be the scapegoat for our situation.
My wife and I stayed because we want to raise our two teenage daughters in this community. It takes a village to raise a child. This is the village we choose. Kathryn and I evolved so we could face it with all of you here. Face it and not go broke.
I am a proud member of Keys health care. There are many more. This is another storm we will get through as the community we are. But it’s at least a category 4.
Sincerely,
John W Norris III, MD FACP
