Health

Ingham Regional Medical Center in Lansing will start laying off about 7 percent of it’s workforce this week.

Interim hospital CEO Patrick Salow says a 10 percent decline in patient numbers over the past year is forcing the staffing cuts. He says the layoffs will affect the hospital’s nursing staff, but the layoffs will also affect other divisions like the finance department.

“If we’ve got fewer patients, so there’s fewer bills to send out, do we need as many people to process bills for example."

The total layoff will be between 100 and 150 hospital employees.

The country is facing a nursing shortage, but schools in our region can’t keep up with the demand for nursing education.

As we reported in our first story, that’s partly because there are a limited number of clinical settings where student nurses can work with patients.

Now, to augment the clinical experience, some nursing programs are enlisting the help of a newfangled dummy, wired with smart technology.

Actually, calling these high tech mannequins “dummies” might be a bit insulting.

Forget those passive plastic torsos you’ve seen in CPR demonstrations. We’re talking about high fidelity mannequins, remotely operated by IT guys with headsets and laptops.

Larissa Miller runs the nursing simulation program at Lansing Community College. She can wax poetic about the virtues of the school’s simulated man.

“Our mannequin can shake,” she said, “which is great, we make him have a seizure right in the bed. He can sweat and it starts pouring down his face. He blinks, he breathes, he has pulses…”

He talks. And his female counterpart can even give birth. Miller has been a nurse for 19 years and she says the technology is exploding, "simulation is absolutely one of the fastest paced things I’ve ever watched in education," she said.

Nursing is a hot career.

The federal government says the field will create more new jobs than any other profession this decade — almost 600,000 jobs by 2018.

But there’s a bottleneck.

Schools in our region can’t keep up with all the people who want to become nurses or other health care workers.

In the first of two stories, Changing Gears is examining some of the high tech tools schools are using to help ease the training crunch.

A new study says overuse of antibiotics is still a big problem, fifteen years after the Centers for Disease Control began a campaign to stop the practice.  

Marianne Udow-Phillips is head of the University of Michigan’s Center for Healthcare Research and Transformation.  She says antibiotics do not work for viral infections.  And the more physicians over-prescribe antibiotics, the more pathogens will develop resistance to the drugs.  But she says patients and doctors alike haven’t gotten the message. Udow-Phillips says:

"We’re just sick for a long time and we just want that magic pill to fix us... But if we have a virus, an antibiotic is not gonna help.  And sometimes physicians cave in to the pressure from families who say, 'just do something'."

Udow-Phillips says drug-resistant staph has become a huge problem.  In fact, more Americans die every year from antibiotic-resistant staph infections than AIDS. 

The practice of overprescribing the drugs is a bigger problem in some parts of Michigan than others, the study found.  In Holland, only about 10% of children who saw a doctor for an upper respiratory viral infection were given a prescription for antibiotics.

But in West Branch, nearly 68% of children with upper respiratory infections were given a prescription for an antibiotic.

Udow-Phillips thinks the differences in prescription rates is most likely because the CDC campaign focused on pediatricians rather than family physicians or internal medicine specialists.  She says more children may be seeing family physicians in areas like West Branch.

Udow-Phillips says the worst part of it is, physicians are often over-prescribing so-called "broad spectrum" antibiotics, when "narrow spectrum" antibiotics would, at least, do less harm.

The Michigan House could vote on a bill this week that protects doctors who say “I’m sorry” from having the comment used against them in a lawsuit.  

Rick Boothman is the chief risk officer for the University of Michigan Health System. The U-of-M adopted a policy 10 years ago to encourage doctors to show compassion and sympathy when a medical procedure goes wrong.

“The practice of medicine is inherently very risky and when things go badly, it can feel very punitive. Historically, we have chilled the communication between patients and physicians because physicians are afraid of saying anything that’s going to get them into trouble.”

Boothman says it’s impossible to tell if the policy is the cause, but the number of malpractice lawsuits against his hospital has gone down in the past decade.

The bill before the Legislature would not shield doctors from liability if they admit a mistake.

Fewer than 200 people have signed up for Michigan’s federally subsidized health coverage pool. The pool was created for people with pre-existing medical conditions but no insurance.

The managers of the program say there are thousands of openings. But some prospective buyers appear to be put off by the cost.

Even at a reduced rate, the premiums can run as high as $650 a month for people in their 50s and their 60s. Younger people get a lower rate – as little as $180 a month, but it can still be difficult for some people to come up with that much money. 

Some hospitals are offering to split the cost of premiums with patients, or to direct people to foundations that can help with payments.

Kevin Downey, who is with the Michigan Health and Hospital Association, thinks there are dangers to avoiding insurance.

“Those without coverage are in situations where their conditions worsen and by the time they are actually seen at a hospital in the emergency room there are fewer options and the costs are higher.”

Eric Schneidewind is with AARP of Michigan. He says providing treatment for people with chronic conditions is a bargain for everyone.

“People who do not have insurance who show up at a hospital are costing the rest of us a thousand dollars a year to pay for this, so it’s in our interest to get these people coverage and have them pay what they can afford to pay rather than nothing and have no coverage.”

The pre-existing conditions pool won’t be necessary after 2013 under the new federal healthcare law. After that, everyone will be required to carry coverage through healthcare exchanges, and people can’t be turned down for a medical condition.