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Mayo: Albert Lea decision can't be delayed

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More than 100 people opposed to Mayo's plans for the Albert Lea Medical Center talk with Lt. Gov Tina Smith before she enters a closed meeting on the issue Aug. 31 in Albert Lea.
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In June, I had the honor of being named the leader for the southeast Minnesota region of Mayo Clinic Health System. As part of this transition, I've had the privilege of meeting with other leaders and community members throughout the region we serve, most recently in Lake Mills and Kiester. We've had productive and candid conversations about how we can continue to provide compassionate and high-quality care while facing real and pressing issues around the changing health care landscape.

These conversations all point to a common goal: preserving the availability of health care in rural communities for current and future generations.

People are passionate about having access to high-quality, local health care, as evidenced by the strong reaction to our decision to shift some of the services in Albert Lea and Austin. We take decisions such as these very seriously. In fact, a multi-disciplinary team consisting of staff from across both Albert Lea and Austin carefully studied the issue for more than 18 months before determining the best course of action.

Detractors are quick to accuse Mayo of doing this to increase profits. In fact, transitioning these services requires the investment of millions of dollars in remodeling and retooling our processes. This plan is a thoughtful solution to improve staffing levels and achieve long-term sustainability for health care in Albert Lea, Austin and the surrounding areas.

It is not motivated by, nor is it expected to achieve, short-term profits.

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Crisis for rural hospitals

The issues facing rural hospitals across the country are not well known outside of our industry. These challenges are not unique to Mayo or to southeast Minnesota, and they will not be solved by an additional or different provider in Albert Lea. In conversations with city, county and community leaders, as well as interactions with the lieutenant governor and the attorney general's office, we are trying to convey the impact of the national provider shortage on rural communities, and our commitment to responsible stewardship of the staffing resources we have available to us.

Since 2010, more than 80 rural hospitals have closed, and a recent industry study revealed that more than 670 rural hospitals across 42 states are vulnerable to closure. Closures like these and other significant changes at hospital systems across the country have been driven by shifting demographics, a significant physician shortage and changes in patient care.

Here's an example of one such change in patient care: An appendectomy that used to require a 5-inch incision and a 5-day hospital stay now can be done laparoscopically (with a few half-inch incisions) on an outpatient basis. Examples like this abound. Consider the continued trend of declining inpatient hospitalizations and childbirths — both have dropped by about 50 percent in the past two decades — and the problem is clear: Our rural communities have hospitals that were configured for a time past—a time when doctors largely worked on their own and many more diseases and procedures required an overnight hospital stay.

Health care organizations everywhere are spreading increasingly scarce staffing resources across half-filled hospitals, with intensive-care and birthing units that care for a very small patient load (for instance, an average of one birth per day on each campus, in our case) at ever-increasing costs. This situation is not sustainable, and ignoring it would jeopardize the future availability of care in Albert Lea and Austin.

Decision can't be delayed

Unlike the 80 rural hospitals I mentioned, our medical center in Albert Lea is not closing. We are very much continuing to offer services in Albert Lea. In fact, it's our responsibility to continuously evolve in the same manner as the Mayo brothers did from the beginning. That's why we are transitioning overnight hospitalizations and surgeries requiring overnight hospitalization, ICU and childbirth from Albert Lea to Austin and moving behavioral health services to Albert Lea – all the while preserving the services our patients use most in each location.

We can't pause in this effort, as many have suggested, because hospital staffing has reached critical levels and we cannot maintain both ICUs any longer.

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Knowing that shifting services between Albert Lea and Austin is the right thing to do doesn't mean it's easy. I grew up in a rural community, and I appreciate firsthand how important health care is to a local identity and a vibrant economy.

We've made a firm commitment to improve the way we communicate with the community about the upcoming changes. We're conducting dozens of consultative meetings with elected leaders, local business groups, and service clubs, and community stakeholders. These efforts will continue.

We are listening closely to the community's ideas. Just a few weeks ago, we announced that we will add short-stay observation beds in Albert Lea to prevent unnecessary transfers. We also announced we will stage the implementation of our inpatient surgery transition across early 2018 and will use the time to work with community leaders to address concerns such as transportation.

These initiatives are the direct result of community feedback, and we will continue to seek out additional ideas and input.

We are investing $720,000 in improvements to grow Albert Lea to serve as a state-of-the-art cancer hub, adding new imaging equipment, and creating an integrated environment for behavioral health care and addiction services. These are diseases and services that touch most families at some time in life. We are also investing an additional $2.75 million in a new hospital cooling system and $600,000 in a new CT scanner.

Further, we are working with local community leaders in the towns where we have rural clinics to identify ways to redesign the way we provide rural health care.

We consider it a privilege to be entrusted with the health of the communities that we serve and we seek to be good stewards of that responsibility. Ultimately, our commitment is to make care more available and more affordable. We stand ready to work with legislators, community leaders, the cities and towns we serve, and our patients to advance these shared goals.

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