‘It Takes a Village’

by Madeleine Maccar | Oct 29, 2024
‘It Takes a Village’
Health care, with one foot in the business world and the other in the service sector, necessitates a harmonious balance that aims to both remain on the cutting edge of medical advancements and provide capable, compassionate care that’s affordable and accessible to everyone. 

And while investing in high-tech tools, pivoting to address unprecedented global health crises, cultivating an adaptable workforce and supporting community partnerships are all part of what it takes to offer unmatched health care in South Jersey, medical professionals have ardently emphasized the need to prioritize holistic patient care in recent years. Whether that means gravitating toward minimally invasive procedures that reduce both recovery times and risks of infection, delivering painstakingly individualized care, or treating people rather than their diagnoses, diseases or MRI images, the region’s medical providers are embracing the inherent humanism of their roles by centering their patients’ needs, wants, fears and expectations to ultimately drive better health outcomes. 

“We specifically look for students in our admissions process who are very interested in the humanistic side of medicine,” affirms Annette C. Reboli, MD, dean of Cooper Medical School of Rowan University (CMSRU), adding that the school’s Edward D. Viner Humanism Center is an additional asset advancing that quality among the continuum of medical students, residents, physicians, faculty, nursing staff and other health care professionals “to ensure the humanistic practice of medicine and prevent burnout.” And as she additionally notes, “It’s been shown that those who take the time to be humanistic with their patients and compassionate actually feel better about their work, there’s less burnout. It doesn’t take that much time: I think it boils down to a couple of minutes to deliver compassionate care. I think that’s key.” 

Taking into account everything that influences a patient’s wellness—their ability to access healthy food, mental health, support network, significant stressors, socioeconomic background and physical location, just to name a few—is what Dr. John Matsinger, COO at Virtua Health, describes as a “back to basics” approach that considers the vast network of influential factors impacting one’s overall health. 

Assessing a patient by piecing together not only their medical history but also external variables allows doctors, nurses, specialists and other medical professionals to understand their patient more completely. That, in turn, ideally yields both a more accurate assessment of an issue’s root cause and the most feasible course of action. As an example, Dr. Matsinger points out that someone without access to reliable transportation is going to have trouble going to onsite appointments, getting all their preventative screenings, or even securing a safe ride to and from outpatient procedures.

“I think that some of the biggest challenges are things that we’ve known about for decades, things that we call either ‘social determinants of health’ or ‘social drivers of health,’” he begins. “It’s making sure that people have what they need close to home, whether that’s transportation, food, housing or making sure that people get screenings because screenings are the best thing we can do to prevent diseases down the road. We spend a lot of time looking at what those social drivers are and trying to address them as best we can. We realize we can’t do it all ourselves: It takes a village, and we’re committed to being part of that village. With housing, we’re working with The Michaels Organization and the city of Camden to bring affordable housing close to [Virtua Our Lady of] Lourdes Hospital; we have our food-insecurity programs where we have mobile farmer’s markets, mobile grocery stores, our Food Pharmacies in Camden as well as Mount Holly. Transportation’s also a huge issue, so we have a program called Ride Health, which is essentially like Uber or Lyft that gives people a ride so they can get to things like their treatments. … You’re probably not going to get those higher-end treatments if we don’t address those basic needs. I don’t think you’re going to prioritize getting your medications if you can’t get food.”  

That confluence of external factors is why Dr. Reboli agrees that “with the social determinants of health, it’s often said that your zip code is very important to your overall health and longevity: Where you live, where you play, the environment you’re in—it’s all important in addressing those disparities.”

In addition to systemic challenges that the region’s medical professionals are striving to overcome, Dr. Reboli points to additional “major issues that aren’t just specific to New Jersey because they are national trends” that today’s care providers are keeping a watchful, proactive eye on in the hopes of preventing them from becoming overwhelmingly untenable for not only a society to collectively navigate but also health care professionals to handle. Those challenges include a veritable mental-health crisis exacerbated by COVID, an inadequate number of practicing psychiatrists to properly deal with that alarming uptick and the rise of substance addictions. 

Of course, patients aren’t the only humans to factor into the health care equation. Even with the rapid rate of change seen in today’s technological landscape leading to the incorporation of both robotics and assistive AI into the medical field, those tools are intended to be purely supplemental—a second pair of eyes assisting rather than replacing a professional, as Dr. Matsinger points out—and are nowhere near sophisticated enough to rival the talents and training of professional doctors, nurses, nurse practitioners, physicians assistants, specialists and others comprising the health care workforce.

And those very human individuals taking on those demanding roles are subject to the same burnout that any other worker is at risk of experiencing. That burnout is contributing to a dangerously diminished talent pool, as is the dovetailing trend of a considerable number of doctors reaching retirement age. Pair that with an American population that’s also aging and will need greater care to remain optimally healthy in their golden years, and Dr. Reboli is understandably concerned about the oncoming numerical disparity between physicians and patients.

She cites some sobering statistics from the Health Resources and Services Administration (HRSA), with two especially standing out as prominent warnings. One is its prediction that the nation’s number of primary care physicians (PCPs)—estimated to be roughly 268,297 in 2021 per a Nov. 2023 report—is expected to face a shortage of 68,020 full-time equivalent PCPs by 2036. That same report notes many PCPs started offering behavioral health and OB-GYN services, making those providers even more invaluable to the patients who rely on them for specialized care. The other prediction is that HRSA has identified New Jersey as one of 23 states poised to be significantly impacted by that looming shortage.

But Dr. Reboli also notes that CMSRU is working to combat that approaching dearth of professionals in a number of ways, particularly with its accelerated three-year primary care track, or its PC3 program. While she says that most graduate from medical school in four or occasionally five years, PC3 allows especially motivated students looking for a career in either primary care internal medicine or pediatrics to earn a doctor of medicine degree in three years through a schedule streamlined to accumulate knowledge and experiences more quickly so their education isn’t compromised, but rather optimized. Those graduates then have an opportunity to finish residency training in the residency programs at either Cooper or other institutions throughout the country. 

There are other ways to minimize that impending shortfall, too. 

“With the physician shortage, part of the solution is to create more physicians,” Dr. Reboli says. “The other part of the solution is to have other health care providers—nurse practitioners, physician’s assistants—practice to the limit of their licenses, to maximize the use of those individuals and then reserve the physicians for the things that only physicians can handle.” 

Dr. Matsinger also explains that Virtua has been mindfully incorporating technology into its practices to assist physicians, which comes with the benefit of both serving as an additional tool and offloading tasks. Voice-to-text note-taking during patient visits allows a practitioner to be fully present in the conversation while providing patients with detailed notes. What’s more, telehealth and in-home care, and advanced robotics that assist with everything from exams to procedures are all ensuring the hospital system keeps pace with modern advancements while extending a helping hand to providers so their facetime with patients seeking care, compassion and insights is as beneficial as possible.

While the challenges to come are many, the region’s health care professionals are proactively demonstrating that they’re equal to the task of caring for their neighbors, while also addressing the needs of today and anticipating tomorrow’s. And they are optimistic about whatever the future brings.  

“I think the future is bright: There’s a lot going on, whether it’s with us or the other local health systems in the southern New Jersey/Philadelphia region. There’s a lot of innovation coming out of this area,” Dr. Matsinger says. “We’re not just putting health care technology in the patient’s home, we’re innovating technology in the hospital. We’re in the process of setting up four different research institutes with Rowan focusing on cardiovascular transplant medicine. We’re really looking at those social drivers of health to see how do we help with inequities, how do we keep pushing health care forward for all, and we’re really excited about that. I think that getting close to the patient’s home, getting deeper into the community, is going to result in great health care outcomes in the future.”

And as Dr. Reboli notes, a good medical education is one that empowers the next generation of practitioners who’ll be furthering medicine in ways we haven’t even dreamed of yet while also inspiring them to absorb as much knowledge as they can so they’re ready to face an unknown future.  

“Especially as the rate of change ramps up, first and foremost, you have to give [students] a solid foundation for them to build on,” she explains. “Beyond that, you have to encourage lifelong learning, information literacy, their ability to review the medical literature, and you do have to watch the trends. We’re preparing our students not for the practice of medicine that we have, but for the future. It’s a future that needs them to be adaptable, emotionally intelligent, flexible and lifelong learners. They’ll see patients at some of their happiest moments, when they’re sad, when their families are devastated, and they’ll need to develop their resiliency so they’re able to help their patients but also take care of themselves.”


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Published (and copyrighted) in South Jersey Biz, Volume 14, Issue 9 (September 2024).

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Author: Madeleine Maccar

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