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I hope my finger is recovering from months of vicious finger pointing between the University of Minnesota (Physician and Government) and Fairview Health Services. The merger of Fairview and Sanford Health was put on hold. We can now, hopefully constructively, move forward and meet the medical needs of the people of Minnesota.
Governor Tim Waltz has taken an important step by creating a task force at the University of Minnesota to consider the future of health sciences. He put this task force in the hands of the talented and highly skilled Jan Malcolm, a recently retired state health commissioner. As the governor said in his announcement, the university’s health sciences program provides “important education, training, and research to support the next generation of health professionals and provide quality care for Minnesotans.” providing.
What does this mean compared to Fairview? TBD. Universities need community partners. Fairview was the logical choice. Once the wounded egos of the leaders of both organizations are healed, cooperation between them will likely continue, in the best interests of both organizations and their patients.
But my concern is not the relationship between the university and Fairview. It is with the Special Committee and its goals. What are the priorities? Should the task force consider more broadly the medical needs of Minnesotans?
Medicine is a mess. It’s fragmented, very expensive, and often very difficult to access. The current healthcare system is exhausting healthcare providers. Both nurses and doctors had high levels of burnout, exacerbated as a result of the pandemic. We are facing a critical shortage of nurses and primary care physicians. And if the current survey of both nurses and doctors is true, we could see mass retirements in the coming months and years. I agree with that perception, but the current medical industry is more about profits than patients. Too many nurses and doctors are leaving because they feel this is immoral.
This dire situation has a direct impact on Minnesota’s current health care. The Minnesota Department of Health releases weekly statistics on hospital occupancy in Minnesota. It started during the pandemic to help health system leaders work together to identify available beds for patients with COVID-19 and other illnesses.
Now the pandemic is over. The novel coronavirus is endemic. Very few people need hospitalization. However, adult beds are still 97% occupied in both ICUs and medical/surgical beds in the Twin Cities metropolitan area. Due to the lack of transitional and long-term care beds, many patients cannot be discharged. As a result, many patients who require hospitalization spend extra hours and days in the ER, waiting for a bed.
This is a precarious situation. We cannot afford to deal with future crises, whether it be a surge in infections or mass casualties. In fact, there is no shortage of physical beds. There is a shortage of nursing staff for these beds in hospitals, transitional care and long-term care.
The facts are frightening. We spend 20% of our GDP on healthcare. This is twice his average for other developed countries. But our health is worse than all these countries. Our life expectancy is declining and shorter than all European countries. “Deaths of despair” due to loneliness, drug overdoses and suicides have increased dramatically. Many hospitals and long-term care facilities are in dire financial straits. But companies like UnitedHealth, along with the biotech and pharmaceutical industries, are making huge profits. Many people, even those with insurance and six-figure incomes, are facing mounting medical debt.
People don’t seem to understand how little value we get from healthcare. Healthcare accounts for only about 10% of the reduction in premature death. The main determinants of our health are genes (parents), lifestyle choices (smoking, drinking, exercise, etc.), and socioeconomic status. We overestimate medical tests and treatments.
So how does the Governor’s Task Force plan to solve these dreaded problems? Can not do that. What it can do is let the University of Minnesota do the work. Not just academic health centers. University-Wide: School of Public Health, School of Nursing, School of Hospital Administration, School of Law, School of Business. The University of Minnesota is the academic and research center of the state. This university is a land-grant university with a mission and obligation to serve the residents of Minnesota. We must do our best to solve these problems.
So, Ms. Malcolm and Governor Waltz, please tell the University of Minnesota to do its job. Establish an evidence-based medical center. That way, unnecessary/undesirable medical care (30% of medical care) can be eliminated. Center for Shared Medical Decisions — Empower patients to make more informed medical decisions. Medical Center for the Elderly — not present on university since 2001. Medical/Nursing Workforce Centers — Ability to anticipate and address shortages of doctors and nurses. Center for Medical and Nursing Burnout — Understanding and addressing the etiology of this critical problem.
Health care is grossly oversold and underperforming in our country and state. Let the University of Minnesota do the job of solving these difficult problems. The only thing we should fear is that the profits of some of these very wealthy companies will decline.
Dr. Vic Sandler is a geriatrician and specialist in hospice and palliative care.