Experts Discuss Opportunities and Barriers in the Johnson County Healthcare System at Aspire Virtual Workshop

By Aspire Economic Development + Chamber Alliance | | 2.13.24

Leading healthcare providers in Johnson County met on Tuesday, February 6th for the online State of Healthcare Workshop to inform the business community on the financial, social, technological, and economic conditions of hospitals and the medical professionals, and patients.

Aspire hosted the virtual event and its Vice President of Economic Development, Amanda Rubadue, led the discussion with three panel experts from Johnson County’s healthcare sector: Dr. Christopher “Topper” Doehring from Franciscan Health, Dr. David Dunkle, MD from Johnson Memorial Health, and Pam Stirling, Director of Nursing Services at Community Health Network.

Rubadue kicked off the talk by first asking the panel: “what has life been like since COVID, how has healthcare changed?”

The COVID Pandemic realized for many the reality of limited resources of emergency services, hospitals, and medical facilities. Shortages of beds and spaces for patients were a major cause of concern then and continue to be an issue now.

“Our patients here on the south side were constantly waiting for transfers for beds at facilities, just due to sheer volumes,” said Pam Stirling. “Patients were also waiting for discharges out of those facilities and sometimes it's hours or it's days before we can get patients in. It's all a matter of how critical the need is.”

“Can they go to an outpatient center? While that may seem very easy, the resources for people to get into some of even these outpatient clinics or to get seen quickly is just a challenge across the board,” she added.

Rubadue transitioned the panel discussion to the supply of quality mental healthcare providers to serve the Johnson County community and what is being done to impact the workforce pipeline in those areas.

“One of the things we hear from the nursing program, for example, is that a lot of places would expand their enrollment if they had the places to do the clinical training,” said Dr. Topper Doehring.

“As hospitals, we certainly have the opportunity to support that education and that workforce growth by creating more opportunities for those nursing students. We want all other health professional students to get their clinical training as well.”

Dr. David Dunkle as President and CEO of JMH, mentioned some of his education and workforce networks that are important to keep his medical facilities staffed with the highest quality care providers.

“The big thing is partnering with other Members of community, like Ivy Tech,” said Dunkle. “We also have great partnership with IUPUC (Indiana University-Purdue University Columbus) for nursing as well as South College, who we’re hoping to expand our relationship with soon.”

“But it's also about starting young too,” Dunkle added. “We've revamped our volunteer program here at the hospital and are trying to get more pre-med students.”

Dunkle discussed institutional barriers in building up workforce pipelines for hospitals in his network.

“We try to increase the workforce, but we're slowed down by government regulation. For instance, one of our great partners in the community, Franklin College.

They'd love to expand their PA (Physician Assistant) program, but they have to go through so many regulatory hurdles. You can't just say ‘next year we want to have seven more students’, it's not that easy and government sometimes slows down our ability to expand and create those slots.”

Dr. Dunkle and the panel’s views on burdensome government regulations on hospital staffing shifted the workshop discussion to Rubadue posing the question: “what are the biggest barriers to receiving healthcare today and what are doing to remove or alleviate those barriers?”

Pam Stirling emphasized the lack of funding from the state level of government that can contribute to the limited resources and capabilities of hospitals to provide care when demand is high.

On the issue of funding and healthcare costs, Dr. Dunkle raised concerns for the finances of patients in Johnson County. He stressed that insurance can oftentimes be a barrier for both doctors and patients.

Dunkle mentioned instances of surgeons sometimes having to wait 60-90 days after surgery to hear back from the insurance company.

Rubadue then shifted the conversation to what would become of the Johnson County healthcare system looking 25 years into the future.

“I feel that technology is only going to continue to get more advanced whether it's in the realm of nurse training or in AI, I feel like technology is going to really change how we do health care overall,” said Stirling. “While that's great, I think it can also be scary for some and they wonder, ‘what does that look like?’, ‘What impact does that have on me?’”

“As we continue to have shortages for certain nursing positions, the question is also whether the position can be AI generated,” added Stirling. Stirling admitted that it will be difficult to tell where healthcare will be in 25 years, but she asserted that in as little as five to ten years healthcare will be intertwined with AI technology.

Dr. Doehring explained the common transportation and scheduling barriers can be overcome as he has seen with patients in the increase in use of “telehealth” services or virtual healthcare visits.

“Patients are thinking: Why would I drive all the way to the Doctor’s office if I can just dial in and get the appointment, but the advantage for us is that we're able to extend specialty care into smaller hospitals that may not have enough demand to employ a full-time or multiple full-time providers. Connecting with patients virtually is a force multiplier for our teams.”

Dr. Doehring marveled at some of the advances in technology he had witnessed in the past two decades of his practicing career and was optimistic about the next 25 years in terms of technological advancements.

“We're able to measure everything hour by hour, minute by minute with the latest bedside patient monitoring equipment,” he said. “Having some of these machines making sure that the humans involved are more reliable, not missing things, not overlooking things, I think is a real exciting development in terms of improving quality.”

Dr. Dunkle commended medical training programs in Indiana and praised Community Health and Franciscan in particular for their work in building Johnson County’s hospital care workforce. While recognizing the work of healthcare professionals, Dr. Dunkle also painted a realistic picture of the system as a whole.

“From the point of view of family physicians, they talk about a shortage predicted in the next 10 years. We could see a shortage in over 100 thousand physicians and/or family docs,” said Dr. Dunkle. “I think the government needs to provide support to help hospitals expand these slots. We also have to decrease educational costs for people that are willing to go into those fields.”

“I get on my soapbox about the inefficiency of healthcare particularly in primary care sometimes,” Dr. Dunkle added. “We're seeing it enhance. We've had to be overly reliant on nurse practitioners and PAs to provide care. They do a lot of good, but we can't say that an APP (Advanced Practice Provider) is the same as a physician, because the training is not the same.”

Rubadue brought the panel discussion to a close and asked about common misconceptions people have regarding hospitals and healthcare, and how these misconceptions can be combatted.

Dr. Doehring and Pam Stirling shared Dr. Dunkle’s concerns about public understanding of the economics of hospital administration and the difficulties of navigating the maze of public policy.

“Right now, if you look at who's making money, it's not the hospitals. The pendulum has swung in favor of the insurance companies,” said Dr. Dunkle. “It's unsustainable as labor costs and supply costs continue to rise. We spend more on healthcare than any other nation.”

Dr. Dunkle has also witnessed rural communities struggling with limitations to access hospitals and EMTs (Emergency Medical Technicians).

“It's embarrassing that people have to go drive 45 miles to deliver a baby. It's embarrassing that a family doctor can't make a living in a small town. You look at the state, we cannot keep going the way we're going, there's going to be fewer hospitals. It's inevitable,” Dr. Dunkle added.

“I'll be honest, our state leadership and our state government doesn't get it. If you look at bills like House Bill 1200 that wanted to cap reimbursement at 200% of Medicare for state employees, which they admitted would probably raise costs on hospitals across state, it caused 85 million dollars in losses. Things have to change,” he said.

The panelists responded to questions from the audience via chat. Despite state and national issues with the healthcare industry and public policy, Community Health, Franciscan, and Johnson Memorial all had commitments to continuing to build well-trained workforces that respond to Johnson County and Central Indiana’s public health needs.