There are a lot of reasons for that though. I work for a hospital system and just shut down our peds service line because most hospitals that are big enough to have a peds service in the first place also happen to be near enough to a metropolitan area that has a dedicated childrens hospital and parents will drive an extra 30min to take their sick kid to a childrens hospital in lieu of their community hospital. So we had a 6 bed peds inpatient unit with an average daily census of 1. Meaning we staffed a 24/7 pediatric team to care for an average of 1 kid per day. And kids, more than any other demographic, have the highest rates of Medicaid coverage which has reimbursement rates that donтАЩt even costs. So most hospitals with smaller peds units operate those departments at a complete loss. With the average RN right now making $65-70/hr we canтАЩt afford to sustain departments at a loss anymore.
Wait...where are these nurses making $65-70/hr???? I gotta move there!! But I agree. Work for a hospital system that moved all heart surgeries to one location in order to be better rated on sts score (by combining the pt population being counted as one location) and basically increase revenue, and be able to advertise that score. Unfortunately lots of decisions like that are made, similarly to the peds being elimated where you are, I think with the end of the Covid assistance decisions like that will continue to happen.
I am in Idaho and yeah, clinic RNs no less are making $63.94 per hour. Cushy hours, no OT, no nights/weekends. ItтАЩs insane. Seattle ChildrenтАЩs Hospital just lost a collective bargaining battle with WSNA and brand new RN fresh out of school are starting at $50/hr with an expected 49% pay increase over the next 3 years. I work as a strategist so am often at the forefront of decisions precisely like that. TheyтАЩre never easy but ultimately thereтАЩs so many factors that go into them and at the end of the day, itтАЩs a balance between long-term financial viability/survival and continuing to provide as many services and as high quality patient care possible.
Holy cow! I work in Ohio (live in ky- we are on the border) and was happy I got a $1 raise last year to push me at $30 hahaha. Yeah, I think all of those decisions are much more complex than they seem on the surface when you factor everything that has to go into them.
Thanks for contributing SC, I think one of the beauties of this comments area is that we have people actually working in many fields. When we see our areas oversimplified/mischaracterized by reporters (God bless them, the world is super-complex, how do we expect them to get it тАЬrightтАЭ when itтАЩs so complex and there are so many views)? ItтАЩs kind of like peer review for scientific papers, except better because itтАЩs open and involves practitioners. Thanks again!
I _do_ understand the economies of scale operating here; it's the same logic that's leading to the closure of OB units in smaller hospital systems.
I guess what I would argue is that certain medical servicesтАФpeds, obstetricsтАФshould operate as loss leaders.
And that probably every small hospital doesn't need expensive equipment (MRI machines, etc) that they then have to pay to keep maintained and updated, and _overuse_ to justify the cost of the purchase.
Yes and no. I certainly do not oppose fair compensation (profit) for health care providers. But I steadfastly oppose the mockery federal regulation/the Medicare cudgel have made of health-care. Not to mention the dystopia created by state-mandated third party for-profit insurance.
Oh, absolutely. Totally agree. The medical delivery system is screwed up twelve ways from Sunday now (my father's expression - what does that even mean?)
Oh how funny, I grew up hearing that phrase as "12 days to Sunday". I still use it sometimes. And yes, I do agree with the original comment. The payment schedules for both doctors and hospitals is so "bass akwards" it has created a lot of the consolidation in the medical industry.
Excellent article. Thanks.
The money quote: "Caring for children is not a major moneymaker for hospitals, and often earns less than adult hospitalization."
Bingo. At this point, I have exactly zero trust in the medical establishment, and I used to be an ER nurse.
There are a lot of reasons for that though. I work for a hospital system and just shut down our peds service line because most hospitals that are big enough to have a peds service in the first place also happen to be near enough to a metropolitan area that has a dedicated childrens hospital and parents will drive an extra 30min to take their sick kid to a childrens hospital in lieu of their community hospital. So we had a 6 bed peds inpatient unit with an average daily census of 1. Meaning we staffed a 24/7 pediatric team to care for an average of 1 kid per day. And kids, more than any other demographic, have the highest rates of Medicaid coverage which has reimbursement rates that donтАЩt even costs. So most hospitals with smaller peds units operate those departments at a complete loss. With the average RN right now making $65-70/hr we canтАЩt afford to sustain departments at a loss anymore.
Wait...where are these nurses making $65-70/hr???? I gotta move there!! But I agree. Work for a hospital system that moved all heart surgeries to one location in order to be better rated on sts score (by combining the pt population being counted as one location) and basically increase revenue, and be able to advertise that score. Unfortunately lots of decisions like that are made, similarly to the peds being elimated where you are, I think with the end of the Covid assistance decisions like that will continue to happen.
I am in Idaho and yeah, clinic RNs no less are making $63.94 per hour. Cushy hours, no OT, no nights/weekends. ItтАЩs insane. Seattle ChildrenтАЩs Hospital just lost a collective bargaining battle with WSNA and brand new RN fresh out of school are starting at $50/hr with an expected 49% pay increase over the next 3 years. I work as a strategist so am often at the forefront of decisions precisely like that. TheyтАЩre never easy but ultimately thereтАЩs so many factors that go into them and at the end of the day, itтАЩs a balance between long-term financial viability/survival and continuing to provide as many services and as high quality patient care possible.
Holy cow! I work in Ohio (live in ky- we are on the border) and was happy I got a $1 raise last year to push me at $30 hahaha. Yeah, I think all of those decisions are much more complex than they seem on the surface when you factor everything that has to go into them.
Thanks for contributing SC, I think one of the beauties of this comments area is that we have people actually working in many fields. When we see our areas oversimplified/mischaracterized by reporters (God bless them, the world is super-complex, how do we expect them to get it тАЬrightтАЭ when itтАЩs so complex and there are so many views)? ItтАЩs kind of like peer review for scientific papers, except better because itтАЩs open and involves practitioners. Thanks again!
Yep. Spot on.
Thanks for this explanation. ЁЯЩП
I _do_ understand the economies of scale operating here; it's the same logic that's leading to the closure of OB units in smaller hospital systems.
I guess what I would argue is that certain medical servicesтАФpeds, obstetricsтАФshould operate as loss leaders.
And that probably every small hospital doesn't need expensive equipment (MRI machines, etc) that they then have to pay to keep maintained and updated, and _overuse_ to justify the cost of the purchase.
Except when the lawyers come calling because there was no MRI to diagnosis a pediatric case of HodgkinтАЩs or whatever.
DonтАЩt underestimate the impact of lawyers in this equation.
What a novel idea - health care separate from the profit motive. Who would have ever thought?
The irony though is without the profit motive the the efficiency deteriorates and progress slows to a snail's pace.
Yes and no. I certainly do not oppose fair compensation (profit) for health care providers. But I steadfastly oppose the mockery federal regulation/the Medicare cudgel have made of health-care. Not to mention the dystopia created by state-mandated third party for-profit insurance.
Oh, absolutely. Totally agree. The medical delivery system is screwed up twelve ways from Sunday now (my father's expression - what does that even mean?)
Oh how funny, I grew up hearing that phrase as "12 days to Sunday". I still use it sometimes. And yes, I do agree with the original comment. The payment schedules for both doctors and hospitals is so "bass akwards" it has created a lot of the consolidation in the medical industry.