Didn’t see this coming, although maybe I should have. This hospital is cutting staff due to reduced income from all those cancelled elective procedures, and apparently also reduced traffic at walk ins.
My local hospital in Kansas is cutting salaries by 10 to 50%; the revenues losses from cancelled elective surgeries and appointments is profound.
I’m not sure I understand the reasoning behind this. So the hospital has eliminated elective surgeries, which frees up staff to concentrate on COVID-19 cases. But because the pandemic hasn’t hit it hard yet, it’s laying off the workers who will be sorely needed when COVID does hit there? 
Or are they under the illusion they won’t get many COVID cases?
Not all staff are going to be useful for Covid-19 cases. People like physiotherapists who would be looking after things like knee and hip replacements. Occupational therapists. HR, accounts, legal, a whole pile of ancillary staff. All the usual corporate middle managers. Whilst the hospital isn’t occupied with many patients, all the cleaning and cooking is on hold. Hospitals run with a huge contingent of non-medial staff.
In my state, vic.au, private hospitals are “going public”. They are accepting state and federal funding similar to what the “public” hospitals get.
I don’t know the details. I suspect that no money has transferred yet, and is unlikely to do much in the future, because I don’t think we are ever gone to run out of public COVID beds in the future. But the arrangements are in place.
The reason I suspect that no money has been paid is that normal state and federal funding is tied to case load. If the private hospitals haven’t been assigned any public patients yet, I don’t see how they would get paid. But I’m not in the loop.
The private hospitals are facing the same problem: elective surgery has dried up. The AUS government wants the beds available, doesn’t want the nurses thrown out of work, and doesn’t want the sector to go into liquidation.
(RNote: Aus has a mixed system. Universal care parallel to private care)
A large hospital in Little Rock is cutting staff.
It sure seems counter intuitive to me. NY has patients stacked in the hallways and even tents outside. It’s a human tragedy and financial good mine too
Realistically their billing revenue will probably double or even triple. ICU charges are extremely high. Some of the bills will never get collected. Uninsured people often can’t pay. People are dying. It’s hard collecting from their surviving relatives.
Shrug…
This is what our largest hospital system is claiming.
My cousin and his wife are primary care physicians who are part of an office-based practice, and don’t do hospital work. They’ve seen patient visits go down by well over 60%, as no one is coming in for routine care nor minor symptoms like they used to. As a result, their office has had to lay off staff. And
In my practice, I am doing much less routine care also, but most of my time is taken up by seeing the sick and high risk patients (only 5-8 a day) or doing pandemic planning/coordination between our 34 sites. Endless conference calls and sitting amongst piles of random data and trying to make some sort of action plan out of it. 
Tell them they will be busy soon enough Qadgop.
It’s happening in Seattle at Virginia Mason Medical Center, according to King-5 TV:.
My understanding was that they’re laying them off because they can’t afford to pay them, because of the decreased revenue. Am I wrong?
As someone that knows the short term physical effects of being on a ventilator for just slightly more than a week, trust me, physiotherapists and occupational therapists are going to be in high demand.
CMC fnord!
The AP has an article about this today: [A mounting casualty of coronavirus crisis: Health care jobs](A mounting casualty of coronavirus crisis: Health care jobs)
If everyone in the medical/insurance industry wasn’t siphoning off every cent possible, maybe they would be better prepared for a short time without AMAZING income. Apparently they should have been charging 10000x the going rate per baby aspirin instead of merely 1000x.
Unlikely given that they don’t do hospital work - unless they volunteer to help in the hospitals for when the storm makes landfall, and their state makes arrangements to give emergency hospital privileges. (Illinois for example is collecting names of all licensed providers willing to sign up under “Illinois Helps”.) But for now primary care and specialists alike are all running well under half of their normal volume. Really the only variable item of overhead they can cut is staff.
FWIW my sense is that in addition to people not wanting to come in for less serious items, there is also a true decrease in need. Social distancing does not only blunt transmission of COVID-19, but also pushed influenza to zero, cuts out strep, URIs, and a host of other person to person infectious diseases.
Now maybe after the storm passes there will be pent up demand for routine care, screening, and elective services, but flexing up to handle the demand will be a challenge. Staffing needs will be great once that happens and overtime opportunities will abound.
Some smaller hospitals and medical groups though have been barely surviving. Even cutting down staff to current volume needs as best they can may leave them shuttered on the other side of this. Even being the broad industry that is going to be swamped the most does not change that they are in the same sort of economic boat as everyone else.
I’m an ER doc in an area that hasn’t yet been hit hard. So our patient volumes are down quite a bit as we encourage everyone to stay home, steer people toward virtual visits and cancel elective procedures. We’ve reduced our hours of physician coverage in the ED to decrease the days that any given person is working (and therefore the number of days that they might be exposed to infectious people) and also to give everyone slack in their contracted hours since we anticipate patient volumes will ramp up in a couple of weeks and we’ll need more physician coverage then. Anecdotally I hear that nurses from inpatient floors are frequently being sent home early due to low patient census.
As a side note, I’m having to explain to some people the medical perspective of what qualifies as an emergency. They have a condition that causes them chronic symptoms and had a surgery scheduled that they anticipated would fix the problem but it’s now been delayed for multiple months as non-emergent. They were hoping that coming to the ED would get them the surgery anyway because their symptoms were severe enough that the surgery should qualify as an emergency surgery. Yeah, no. If your condition is not life threatening, the surgery is not an emergency.
Canada has seen big drops in ER visits and the cancellation of elective surgeries means only serious cases. But payment is a hodgepodge. Many doctors are paid fee for service. Others choose a salary, get paid by roster, get paid for comprehensive care, etc. But after SARS, the backlog of delayed and postponed things was massive and took many months to work through. This will too.
Does the payer system also mean that those with mild symptoms and inadequate insurance are less likely to self refer until they are in dire need?
In my city, and I know of other areas where this is going on, it’s not so much that they’re laying people off as asking them to take vacation time, not using per diems, or cutting part-timers’ hours. It just hasn’t hit here yet, and they want the facilities to be available if/when it does. If it does, they will call in the troops, KWIM?
I have a Facebook friend who is an ICU nurse in Winnipeg, a city of 750,000 that has seen very few cases, and her hospital has yet to see one. Right now, people are basically in that hospital to be born, and to die. She’s never seen it less busy, and she sure hopes it stays that way.
Let me explain why they charge $8 for an aspirin (as an example.)
Nurse contacts doctor to request it.
Doctor writes order.
Nurse transcribes order and sends it to the pharmacy.
Pharmacist processes the order, then has the technician fill it and send it to the floor.
Nurse administers dose, and then charts it afterwards.
(A drug like aspirin would be in a dispensing machine on the floor, but those machines still need to be stocked and maintained.)
Wait. What? Seattle? I thought that was the worst place for it!
Are they laying off people who aren’t employed in the ICU, which is overloaded?