|UMC’s Dr. Lonn Guidry, who has been training interns and residents since 1993, and Dr. Justin Ardoin, the hospital’s chief resident and a regular volunteer at the Lafayette Community Health Care Clinic.
| photo by Terri Fensel
University Medical Center doesn’t advertise and, unlike other hospitals in the area, doesn’t have a sophisticated public relations rep or communications department. But that doesn’t mean you don’t hear a lot about it, most of which is negative. Over the years, University Medical Center in Lafayette has gotten a bum rap. You’ve all heard the complaints — long lines, hours of waiting time.
But there’s a lot more going on at UMC than meets the eye.
A more accurate picture of the facility and the critical role it plays in the Acadiana community lays in the fact that it delivers quality medical care to hundreds of thousands of patients each year, most of whom are employed. The hospital also annually serves as a training center for dozens of bright, eager residents and fellows — many of whom choose to stay in the Acadiana area after completing their required rounds. Besides devoting countless hours to treating the working poor at UMC, all of the hospital’s residents and many of the teaching faculty volunteer at the Lafayette Community Health Care Clinic.
UMC’s patient base consists primarily of patients who are working but unable to afford insurance. Louisiana has 657,000 uninsured people. At UMC, greater than 85 percent of the patient population has no insurance, with the remainder having Medicare, Medicaid or private insurance.
The number of patients seen each year at UMC is staggering. For the fiscal year July 1, 2006, to July 1, 2007, the hospital had 237,010 visits from patients living in Acadiana, southwest Louisiana and even north Louisiana. Servicing a patient population of approximately 71,136 were 987 employees. Licensed beds number 146, with 104 staffed beds. The facility trains 182 medical residents and fellows, and 439 students in nursing and allied health, drawing trainees from as far away as Texas. UMC’s estimated economic impact in overall business activity is $228.7 million.
UMC is part of the LSU Health System, Health Care Services division, which also administers Earl K. Long Medical Center in Baton Rouge, LSU Interim Hospital in New Orleans, Bogalusa Medical Center in Bogalusa, Lallie Kemp Regional Medical Center in Independence, W. O. Moss Regional Medical Center in Lake Charles, and L. J. Chabert Medical Center in Houma. These hospitals share a total appropriated budget of $850.5 million, including $200 million in non-federal match funds and $25.6 million in state appropriations. For fiscal year 2007, total collections at UMC were $118.9 million from the state general fund, commercial/private pay, miscellaneous self-generated funds, Medicare, Medicaid, and Medicaid Uncompensated Care.
Although Louisiana ranks near the bottom of the list in health care, UMC’s outcomes buck that statistic. “Taking the criteria that Medicare uses to score health care and applying it to the health care outcomes that we have in our state hospitals, we score within the top 2 or 3 percent in their criteria in the United States,” explains Registered Nurse Lou Ann Gerard, director of patient relations. “And, it’s because we’re an integrated health care system, we are practicing disease management, and we are using a standard of care method of delivering health care to these people. And, that’s how we can capture these scores and provide better health care for them.”
UMC houses two residency programs — a family practice with 26 residents, and an internal medicine rotation with another 26 trainees. Walking through the residency wing is a surreal experience, almost like viewing a live set of Grey’s Anatomy. Dozens of young doctors-in-training scurry about, following mentors like Dr. Lonn Guidry, a specialist in internal medicine and geriatrics and assistant professor of clinical medicine with the LSU Medical School in New Orleans. Guidry has been training interns and residents at UMC since 1993.
About a year ago, UMC launched a geriatric scholarship program, which hosts two spots for graduates in family practice or internal medicine in a specialized field that teaches doctors how to take care of frail, elderly patients. UMC’s first geriatric fellow will complete training this fall.
In the wake of Hurricane Katrina, UMC inherited additional services from displaced doctors. One of the most valuable was a renal transplant program, which got a big boost when a New Orleans-based transplant surgeon, Dr. Daniel Frey, decided to stay in Lafayette. Since its inception, UMC has performed approximately 64 kidney transplants, which is the only type that the hospital does, and is now a Medicare-approved transplant center.
Budding physicians also assist with disaster relief. After hurricanes Katrina and Rita, many residents and faculty members took care of displaced patients at the Heymann Center and the Cajundome. Like his cohorts, chief resident Justin Ardoin volunteers at the Lafayette Community Health Care Clinic after completing his shift at UMC. On average, the internal medicine residents see 25 to 35 patients on three Thursday evenings a month. The family practice residents cover the other Thursday nights. “It’s a great experience for us,” Ardoin says. “It helps the community out, but we are also learning. No matter how long of a day I’ve had, no matter how tired I am, it still feels good to go over there.”
Settling in Acadiana is a common trend for most residents and fellows at UMC. As experienced doctors retire, these younger physicians fill in the gap to provide care for the growing patient census. “The community in general benefits not only from the care, but also from the physicians who stay here, replacing retiring physicians,” Guidry says. “As physicians retire and our population enlarges, we need not only the physicians to replace the retiring physicians, but we also need additional physicians to take care of the expanded population. And, many of the residents stay here.”
About seven years ago, UMC launched the disease management program, an initiative focusing on five areas — heart failure, diabetes, asthma, chronic renal disease, and breast and cervical screening. The program, which is monitored by LSU’s headquarters in Baton Rouge, ensures UMC follows nationally established guidelines for treatment of these conditions. “We are educating these people to take ownership of what is going on with them, with the ultimate goal of providing a great quality of life if we can,” says Betty Lindberg, clinical coordinator for disease management. “We are required to provide national and regional statistics of how we are doing in our job.”
Patients are sent to this program when identified by UMC, or through referrals from outside physicians. Nurse practitioners in collaboration with internal medicine physicians monitor and treat these specialized patients as needed. “The goal is to get them to a point where they are in their illness to where they are managed and they are stabilized,” Lindberg explains. “I think is our biggest asset is our accessibility,” she says. “And mainly, it’s because patients feel like they matter, and that is huge. Disease management is not an entity that stands by itself. This is a very cooperative effort that goes on through all departments in this hospital. We are kind of like a watchdog, if you will. We really try to pass on what we learn and make sure that we’re all on the same page when it comes to patient care. And, it’s worked beautifully for the most part.”
Outcome measures show that collectively, LSU’s disease management programs, including UMC, are working, with patients living beyond their expected lifespan. “This is because of education, medication, and adherence to guidelines,” Lindberg says. “So, we are seeing good things happen.”