Hospitals Feel Economy's Ills

              Hospitals feel
Sun., Per. 26, 1982 snRKVEPORT-BOSSiKB 77»f Times
economy's ills
By BOBBY LAMB
Times Business Writer
Hospitals have no immunity to the
ills of a depressed economy and the
symptoms of the recession are begin-ning
to show up in Shreveport's medi-cal
community.
While no drastic epidemic has
struck, projected hospital revenues in
general are showing signs of anemia
and some patient rosters are declining
in number — aside from the usual
Christmas season drop — as people
apparently are averting medical care
and postponing non-emergency, elec-tive
surgery.
The treatments being prescribed
for what's ailing the hospitals range
from closer monitoring of hospital pa-tient
counts, to a freeze on hiring, to a
reduction in work hours and en-couragement
of extra time off. And
1983 budgets have been planned some-what
conservatively, especially con-sidering
that the biggest layoffs are
just beginning to hit and more could be
on the way.
The "trend is downward because of
the uncertainty of people's employ-ment,"
said Charles Boyd, adminis-trator
of Doctors' Hospital. "Hospitals
are just like other businesses, they're
going to be affected, too," Boyd said,
and that means individual physicians
are also being hit. "The conversation I
hear in the halls, everybody's business
is down."
When jobs go, not only do wages go,
but also benefits and insurance cov-erage.
And there are 17,000 people out
of work in Caddo, Bossier and Webster
parishes alone, making up 10.5 per-cent
of the workforce in October.
Thousands more are jobless in the geo-graphical
area served by Shreveport-
Bossier City hospitals.
With the near-record unemploy-ment
in mind, other people, particu-larly
those in similar types of work,
fear deeper cuts in local industries.
For those workers there may be "a
need for some elective surgery but he
may not take time off for it because it
might lead to a layoff," said J. Michael
Douthitt, executive director for Phys-icians
& Surgeons.
"Of course, that affects the patient
load," Boyd said.
"I think we're in the midst of coping
with something that's been going on
for the past two years," Douthitt said.
"Certainly, I think people are more
cost conscious and that does impact
decisions in health care."
It's that public concern which
Douthitt believes is showing up in the
P & S budget.
For 1982, growth at the hospital was
projected to be 8 percent. When the fis-cal
year ended Sept. 30, the increase
was about 2 percent, which Douthitf
pointed out is "not a cessation in
growth, but a reduction in growth
From the standpoint of other hospi-tals,
I'd say we were pretty fortunate."
He also said the hospital has yet to no-tice
the seasonal Christmas drop off in
patient load. "Here we are 21 days in
the month and we have not seen the
drop off, which tells me we have some
sick people that don't have an option.'
"This actually started the lattei
part of October or first part of Novem-ber"
at Doctors' Hospital, Boyd said
"We're pretty much holding our own
up until that latter quarter of 1982. 1
think that's when the economic re-cession
began to be felt," he said.
"There's just been a radical decline in
census."
When the 1982 financial books
closed recently, Doctors' Hospital had
shown an increase over 1981. "It
wasn't exceptional and it wasn't bad,"
Boyd said.
Over at Schumpert Medical Center,
Associate Administrator Robert De-
Backer said revenues "held up better
than we expected," though, he said
"They're probably a little short. He
also pointed out that there were over-runs
in costs that hadn't been ex-pected.
"Maybe we haven't felt the full im-pact,"
DeBacker added, since many of
the unemployed are still receiving
compensation from there job loss and
one of Shreveport's biggest layoffs —
940 over at Western Electric — didn't
hit until this month.
Bossier Medical Center, a city-own-ed
facility, more than met its pro-jected
growth rate, but David Beach,
executive director, said the hospital
might have done better if economic
conditions had been better.
"We're ahead of what we budgeted
this year. We're not going way ahead
by any means," Beach said. "We have
to feel we're doing pretty well, con-sidering."
Beach said the Bossier hospital can
attribute its stability to being in a
growth area, which he believes is
underserved by primary physicians.
He said the hospital has plenty of
potential for growth as more phys-icians
decide to serve the area.
He said physicians with practices at.
the hospital appear to be holding their
own. Any reduction, he said, "certain-ly
hasn't been major or that would
have been reflected more in the hospi-tal."
With increased unemployment,
Shreveport's state-owned Louisiana
State University Medical Center is
feeling the pinch on its resources.
"We certainly catch those patients '•
and we are catching those patients,""
said administrator Robert Hall. "We
know that, especially when the;
salaries are cut off and their benefits
play out and their insurance is gone.'-'.
At the same time, the state, facing
its own economic problems, has given
orders to cut back, and the hospital
had reduced its bed count from 507 to
365 beds. It serves about 275,000 pa-tients
annually. "We have patients
who would be here if we had beds.
Right now we're having to turn people
down," Hall said.
In facing the crunch, hospitals con-tacted
by The Times have yet to;
prescribe layoffs as a remedy for their
conditions.
"So far we've managed to weather
that storm," said Douthitt of P & S,
where employment levels have re-mained
constant for the past three
years. "When normal attrition occurrs
... we look very closely, evaluate and
scrutinize what we do to replace that
individual," he added.
"To slow it down without making
any radical moves, you reduce hours
and not hire," said Boyd. And that's
just what's happening at Doctors' Hos-pital,
where 20 beds were eliminated
at the beginning of the year.
"What we've done is just put on a no-hire"
Boyd said. The hospital is mak-ing
personnel reductions through nor-mal
attrition. The medical facility
loses 10 to 15 people per month from
attrition — mostly wives following
their husbands in job transfers. Per-sonnel
levels have been reduced by
about 20 employees through attrition.
"We've cut ancillary services from
40 to 36 hours," Boyd said, and other
medical personnel are being handled
on a daily basis, with employees being
offered time off without pay rather
freely when activity slows up.
"I didn't want to get into a layoff
situation," Boyd said. "That might
happen. We're not going to right now.
We just want to reduce hours. So, we're
sort of piecemealing it," he said. "I'll
continue a no-hire until we see a turn-around
in the census trend."
DeBacker said Schumpert officials
have pared down expenses, in light of
some cost overruns in the '82 budget.
The hospital has reduced its use of re-lief
personnel. "In fact, I don't think
we're hardly using any," he said.
"We just have to keep looking at this
on a day-to-day basis. So, if we have to
react, we can react quickly. We cer-tainly
are monitoring things very
closely."
LSU Medical Center has put a gen-eral
freeze on hiring, Hall said.
With the recession continuing, hos-pital
officials are generally planning
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