Healthcare in the post-pandemic world: hospital is doing more with less, says Thompson Hospital’s medical director of hospital medicine
Q: You’re currently splitting your time between administrative and clinical duties. How are you juggling that?
A: For the time being, given the impact of the pandemic, my time is variable. I do 30% to 50% clinical, which means I have a direct responsibility for taking care of patients similar to any other doctor in the hospital. And the rest is administrative and administrative here means overseeing the quality of care that is being done in my division. Scheduling, making sure the division of hospital medicine is running according to the organization’s rules and priorities.
Q: As far as dealing with the aftermath of the pandemic goes, what are some of the longer-term implications in terms of policy, staffing, etc.
A: As you know, the pandemic hasn’t only affected the local hospital system, but the whole country and world, though it did impact us here in New York state worse than a lot of other states other than maybe California. It affected us at different levels. It affected us in terms of staffing and our ability to take care of a large amount of patients at the same time. In the past we were averaging 55, 65 patients a day. This has jumped up into the 70s, sometimes even above 100. So it did affect our through-put. So this presented challenges to our organization as well as all over with regard to how to recruit enough providers to take care of this large number of patients. Even after the pandemic we still have elevated numbers of patients. This isn’t necessarily COVID-related, but related to the high numbers of patients whose chronic issues decompensated during the pandemic. A lot of them stayed home, a lot of conditions were not being closely monitored. So a lot of them are coming to the hospital. That’s in addition to acute issues like gastrointestinal bleeding, heart attacks, stroke, pneumonia that we deal with on a day-to-day basis. And the pandemic left us vulnerable staffing-wise due to illness, disability and the initial virulence of COVID. And then, with the vaccine mandate, a lot of people did not want to take the vaccine, so you had some people leaving here and there for that.
Q: To what degree has staffing recovered since then? What kind of shape are you in now?
A: I can tell you from our institution point of view we’ve recovered 55%-65% of the staffing we lost during the pandemic. There is an intense plan in place to get back the rest and more that we lost during the pandemic.
Q: How are you going about that?
A: Intense recruitment. We are a community hospital networked with the University of Rochester and have an agreement with multiple local nursing schools and medical schools like SUNY Upstate, so we have a lot of students from different areas of medicine who rotate through us as part of their education and training. This opens an opportunity for us to show them our hospital, our culture. And we end up recruiting some of those graduates to be a part of our hospital. In addition, we have recruitment through a physician and staff recruiter who work through the journals, websites, social media and the community to fill vacant positions.
Q: What are some of the more unique attributes about FF Thompson that you can market when it comes to recruiting?
A: I’ve been with the hospital almost 16 years, since 2007. It’s a community hospital. It’s a part of the community. It was built by the community. And it’s supported by the community. The majority of the leadership is from Upstate New York. They’re from the area, they understand the area. And because it’s a community hospital it functions more like a big family. You can sneeze on the first floor and someone on the third floor will say “bless you.” And because of this really close relationship with the community people come to Thompson feeling more like it’s a second home where they’ll be taken care of to the best of our abilities. With the new leadership that we’ve had since 2011, 2012, it’s brought a lot of resources to us from the university.
Q: What kinds of resources are available to you?
A: We can very quickly transfer patients who are in need to subspecialty care that we don’t have locally to a university hospital, even as far as Buffalo. We have a majority of the central services patients need though, so there’s a lot we can do without having to transfer a patient somewhere else. One example is dialysis, which we didn’t use to have, but we can now offer inpatient dialysis on site. A second is a brand new 12-bed ICU with a critical care team from the University of Rochester. So not only can we take care of local critically ill patients, but we’re actually accepting transfers from some of the smaller Southern Tier hospitals.
Q: For patients who have chronic conditions that spiraled out of control during the pandemic, how have you gone about getting them back to base line?
A: The most important thing is we have an excellent ED staff that is good at identifying when a condition they’re seeing in the emergency room is the result of a chronic condition. So you address the chronic issue that decompensated, you stabilize it and then work with their primary care physicians to get them back on track once they feel well enough to go home. We also have a patient rehab service that helps patients who have been deconditioned. We also work with nursing homes that offer rehab for elderly patients.
Lifelines
Name: Ali Hamdan
Position: Medical director of hospital medicine for F.F. Thompson Hospital. Supervises team of about 30 people – both physicians and advanced practice providers.
Hometown: Beirut, Lebanon
Education: Damascus University, Syria; residency: University of Rochester School of Medicine, Rochester, American University of Beirut, Lebanon
Specialties: Board-certified, internal medicine, American Board of Internal Medicine; board-certified, critical care medicine, American Board of Internal Medicine
Affiliations: F.F. Thompson Hospital; University of Rochester
Organizations: Society of Clinical Care Medicine
Family: Wife, children
Hobbies: Reading, philosophy, theology