MaineHealth is a regional hospital and clinic network covering much of southern and midcoast Maine and a bit of New Hampshire. Maine Medical Center, aka Maine Med, is the 800-bed referral hospital and management center for Maine Health. If you live in the service area of MaineHealth you have reason in be interested in the management of Maine Med. A medical emergency could suddenly make you a patient there.

The Press Herald’s Bill Nemitz has reported the MaineHealth, including Maine Med, immunized all its personnel, about 22,000 people, regardless of their risk of contracting COVID-19 on the job.

In the last 25 years U.S. hospital administrative staff numbers have grown by 75 percent while the number of hospital beds has shrunk. Now less than half of hospital employees are involved in patient care. In the typical large hospital, people working electronically on billing, coding and reporting form the largest group of employees. These people, essential to getting the hospital paid, outnumber hospital beds or nurses. (Uwe Reinhardt, “Priced out”, Princeton University Press, 2019)

Managers of Maine Med and MaineHealth chose to protect their low risk billing personnel before offering vaccine to the older people who look to MaineHealth clinics for care. Given the choice between protecting their high risk patients or the organization’s revenue, they chose revenue. Numbers doses of vaccine consumed were likely in the thousands.

This vaccine diversion raises the question, “Who looks out for patients?”

Hospital administration is a specialty within business administration. Some hospital administrators/CEOs have some background in patient care, but most don’t. Some are strongly committed to their communities; some aren’t. Hospital administrators/CEOs are hired, evaluated and retained to keep the firm running smoothly and in the black. The decision to protect cash flow rather than patients is disappointing but not surprising.

Hospitals originated as places to give nursing care. The decision to hospitalize someone usually hinges on his or her need for round-the-clock nursing. Nurses are most likely to advocate for patient interests in hospital & clinic management. In hour to hour patient care, nurses are being replaced by people with less training. That’s to hospitals’ financial benefit, but not a good thing for patients.

I’m an elderly, retired physician. I’ve taken care of patients and served as trustee in systems with, and without, unionized nurses. On balance I feel unionization of nurses benefits patients. The handling of COVID vaccination by MaineHealth prompts me to speak up. I have no past or present ties to organized labor or any health care entity in Maine except as a year round resident and, sometimes, patient.

Revenue protection is the growth sector in hospital workforce. Hospitals and clinics are staffing up, trying to get paid, as insurers try to reduce payments. It’s the predictable result of our adversarial system. It appears that in the coming decade more nurses will retire than will be trained to replace them.

It’s in our common interest as potential patients to support nursing, so nurses will be there to look after us.

— Special to the Press Herald