CMMC Director Says Proposed Budget Will Mean Reduced Service

              CMMC Director Says
Proposed Budget Will
Mean Reduced Service
By MARGARET MARTIN
Times Medical Writer
Services will have to be cut at Confederate Memorial Medical next
year if the hospital is given only the $12,750,000 budget now indicated by
sources in Baton Rouge, according to Dr. Rod M. Yeager, director of the
hospital.
The $12.7 million budget would be only $699,514 more than the
present fiscal budget which is $12,050,487.
Yeager says this is not even enough to maintain current operating
expenses, much less institute new programs.
To maintain current operating ex-penses,
including increasing medical
costs, raises already given this year, new
positions and merit raises for next year,
the hospital must have $13,009,621.
Both Yeager and Dr. Edgar Hull,
dean of the Louisiana State University
Medical School at Shreveport, point out
that Confederate is not only important as
the medical facility for the indigent of
North Louisiana, but as a training
center.
TRAINING ROLE CITED
Perhaps its most important function
is as the teaching hospital for the new
medical school, which will graduate its
first class in June. But other training
programs are also c o n d u c t e d here,
including residents and interns, x-ray
and radiology technicians, nurses and
nurses aides.
The medical school and the hospital
rise or fall together, Hull said.
Yeager had originally asked the
L e g i s l a t i v e Budget Committee for
$16,832,553, but has cult that down to
$14,581,045 by scratching several new
programs and reducing funds for others.
Medical costs have skyrocketed in the
past five years, Yeager said in an
interview at his office.
Confederate has not kept up, but New
Orleans Charity Hospital has, Yeager
said.
Although they are not the same size,
Confederate and Charity can be com-pared
in terms of services they offer.
Roth are teaching hospitals for medical
schools and both have a full complement
of interns and residents. In addition, both
train nurses, nurses aides and techni-cians.
Research is conducted at both
institutions.
Pointing to a graph which shows
budget requests for both Confederate and
New Orleans Charity over the past five
years, the director said that Confederate
has just not kept up with the rising cost
of medicine.
The chart shows that over a five-year
period Confederate's budget has risen
from $8 million to $12 million, while
Charity's budget increased 70 per cent —
from $28 million to $48 million.
Yeager emphasized that he is not
criticizing Charity, nor does he expect
Confederate to receive the amount of
money Charity receives.
"Our problem is that we have not
kept up. We have let ourselves get
saddled with a budget which has not
increased with i n c r e a s i n g costs of
medical care," said Yeager, who was
named director in January.
How did this happen?
"I don't know," he answered. "I was
not around."
Yeager also said that he is not so
naive as to think that he can catch up
the five-year period in one year.
He said he considers the increase he
is asking now a survival budget.
Using average daily census figures
(the number of patients in the hospital in
a day), Confederate is 29 per cent the
size of Charity. For instance, Confeder-ate
has 400 patients while Charity has
1,330.
Putting the budget on a proportional
basis, with Charity's budget Confederate
would get $14.8 million. Yeager said,
which is more than the $14.6 million he is
asking in the revised proposal.
He does not feel this is an unrealistic
figure, as compared to hospitals of
comparable size.
Yeager also p o i n t e d out that
Confederate spent less per patient per
day in 1970—the latest figures available
— than either Charity or the national
average.
Confederate spent $55 a day for every
patient, while Chariety in New Orleans
spent over $60, and the national average
was $80.
He said he felt the state university
hospitals have been doing "a pretty good
job," but added, "Confederate has not
spent enough per patient per day to give
acceptable medical care."
COMPARES WITH N.O. HOSPITAL
Yeager also said that Charity in New
Orleans spent $1.4 million for equipment
in the past year, whereas Confederate
has purchased only $1.6 million in the
last 10 years, including $98,000 last year.
"We are not keeping up on equipment
needs, if we are compared to a similar
institution — Charity," Yeager said.
Yeager emphasized that he is not
comparing Confederate to Charity as far
as far as size is concerned, but that the
institutions are the only two eaching
hospitals connected with medical schools
in the state.
"Confederate must keep up with
increasing costs of medical care, if it is
to continue to operate," the director said.
—"We are behind we have to catch up,"
he added.
If the legislature approves an inade-quate
budget, "we will have to cut
services," he said.
Yeager would not elaborate on what
will be cut.
However he has already slashed new
programs to bring the budget down to
$14,581,045, f r o m the $16,832,553 he
originally submitted.
Requested earlier was $15,231,234 to
maintain current operating level, plus
handle anticipated w o r k l o a d adjust-ments.
From that, Yeager omitted an order
'for new beds and bedside stands, one
electroencephalograph machine, and an
increase in the number of residents to
bring the $15.2 million down to $13.9
million.
Also in that original request, Yeager
bad a s k e d for $1,601,310 for new
programs.
These were: Surgical Intensive Care
Unit (ICU), equipment and staff, $67,390;
'Medical ICU, $125,214; diagnostic radiol-ogy
expansion, $400,219, for three addi-tional
x-ray rooms to handle an increase
in workload; newborn ICU, respiratory
care center, $87,903; open heart surgery
service, $46,103; cardiac catheterization
laboratory, $120,030; renal dialysis ex-p
a n s i o n , $81,446; medical electronics
department, $40,059; Cooper Road satel-lite
clinic, $212,472; burn unit, $18,428,
and emergency medical service, $217,013.
Yeager has brought the total figure
down to $674,672 by cutting out requests
for radiology expansion; the burn unit
and the emergency medical service, and
reducing the figures of open heart
surgery to $40,353; catheterization lab to
$77,221; and Cooper Road satellite clinic|
to $100,000.
In regards to the intensive care units
which are expected to be ready this
summer, Yeager emphasized that the
units cannot be opened without adequate
personnel and equipment.
"If they cut the budget, we will have
to take a hard look at what to do about
ICU," Yeager said.
Agreeing with him was Dr. Stephen
Glasser who is in charge of the cardiac
and medical intensive care units. He
said, "we can't open the ICU without
proper staffing . . ."
Dr. Erich Lang, head of the Depart-ment
of Radiology, said that Confederate
has purchased no additional equipment
since it has opened in the 1950s. Lang
said that while the department had 50,000
examinations five years ago, it will have
over 70,000 by July.
He said that if additional rooms are
not built, there is a possibility that the
service would have to be run on a
24-hour basis.
This would mean, for instance, that a
patient might, have to fast 16 hours
during the day, so a procedure could be
done at 10 p.m. at night.
It also would be more expensive, he
said.
NOT GOOD FOR PROGRAMS
The situation would not be good for
the training program either, Lang said.
"You can't run a training program in
the middle of the night," he added. "You
disassociate the patient and the film
interpretation."
The number of patients and proce
dures has increased at the hospital over
the past four years, Yeager said.
For instance, records show that for
the years from 1969-70 to 1972-73, the
number of outpatient clinic visits jumped
from 127,290 t.o 158,304; emergency visits
from 8,319 to 10,728; outpatient visits
from 135,609 t.o 168,394; surgical proce-dures
from 5,676 to 6,692 and hospital
admissions from 21,162 to 22,662.
To provide quality medical care for
patients — including private patients
who come for services not available
elsewhere in the community and
quality training for future physicians.
Confederate must have its proportion of
the Louisiana health care dollar, Yeager
feels.