To say Holy Name Medical Center in Teaneck learned several painful lessons from the COVID-19 pandemic could be an understatement. The 361-bed hospital, less than nine miles out of New York City, was widely considered ground zero for the first of the outbreaks across New Jersey in March. But Mike Maron,
Holy Name’s chief executive officer, said he thinks that experience gives the hospital a unique edge: the staff bore some of the worst of the first wave and survived.
“You look at the disease and say ‘I need to adapt rather than force the disease into a fixed way of treating people,’” he said in an interview. That’s a phenomenon plaguing many of the nation’s hospitals overwhelmed by COVID-19 patients and scrambling to find room for people with any other medical needs, he told NJBIZ.
Going into 2021, the hospital will seek to expand its medical training program, after a federal omnibus spending and COVID-19 relief bill was signed into law in late December. Tucked into the spending package is the “Supporting Graduate Medical Education at Community Hospitals Act,” which ramps up the number of medical school training slots across the country.
“With a raging pandemic, an older physician workforce, and an aging population overall, the demand for qualified doctors in New Jersey is quickly outpacing supply,” one of the bill’s sponsors, Democratic U.S. Sen. Bob Menendez, said in a Dec. 21 statement.
Nationwide, the new law could increase the number of graduate medical education training slots by 3,000 every year for the next five years. Maron said that at Holy Name, the law means the hospital can expand its training class size from six to more than 100 enrollees.
“I think the notoriety that Holy Name achieved during the pandemic is going to be a positive influence and factor in students deciding that they want to rotate through Holy Name,” Maron said. “We did demonstrate to the world … we were the most innovative, the most agile and the most quick to respond, and that creates an incredible learning environment for a young doctor.”
The new law was a response to what proponents – like Maron and the state’s Congressional delegation – contend is an outdated federal funding mechanism. In 1997, legislation known as the Balanced Budget Act capped the number of Medicare-funded GME positions at individual hospitals.
With only six residents in rotation through Holy Name at the time, according to Maron, “Medicare rules said ‘well that’s the base year, you’re now capped at six. So if you want to grow your program again, you can but we’re only going to pay you for six.’”
The law “puts us back to zero and says you can start over, you can now grow a program as large as you want, and we’ll reestablish the cap based [on that],” he added.
By 2033 the nation could see a shortage of as many as 139,000 physicians, according to the Association of American Medical Colleges. “[T]he COVID-19 pandemic has made it clearer than ever that more physicians are needed to ensure our patients and communities have access to the care they need,” AAMC Chief Executive Officer David Skorton said in the Dec. 21 statement.
“This legislation is a good first step in addressing the shortage and it ensures that both rural and urban communities will benefit.”
The bill’s recent approval means the hospital officials have only just started to map out the program, including the creation of a curriculum that must be approved by the Accreditation Council for Graduate Medical Education, Maron said. And the hospital needs to bring on full time staff dedicated to just the medical training program.
Holy Name’s existing relationships with the Mount Sinai Health system in Manhattan and St. George’s University School of Medicine in Grenada means that those two institutions would likely be the first to rotate in students and postgraduates, according to Maron. The earliest the new programs could go online would be in 2022, likely after the COVID-19 pandemic ends and with an eye toward rebuilding the post-pandemic medical workforce.
Nationwide, medical schools have identified a phenomenon known as the “Fauci effect,” a reference to the nation’s top infectious disease expert, Dr. Anthony Fauci, who’s garnered global recognition amid the COVID-19 pandemic. The AAMS reported surges in medical school applications across the country. Geoffrey Young, the AAMC’s senior director for student affairs and programs, said in December that many applications “have been motivated by seeing heroic doctors on the lines of the COVID-19 pandemic.”
Maron said he expects the “Fauci effect” to drive up applications. But with a looming burn-out from the pandemic and years of reluctance by young people to become doctors, health professionals and medical workers, he expects the two to “cancel themselves out.”
He cites such factors as the risk of malpractice claims and “how the insurance companies dealt with them, the compensation, with how they get paid, has not kept pace with other sectors of society.”
“People are excited and saying … ‘I want to commit to helping others,’” Maron said, but “the burnout side once you get in is still very real.”
Maron said he’s still confident that the addition of 100 new health professionals, even though a drop in the bucket, could still be significant, if at least for Holy Name and its 1,100 active doctors. “It’s a long-term … fix, but one that’s absolutely necessary.”