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Carolinas Medical Center president shares concerns facing health care administrators

BOONE—What is it like to be the chief administrator at one of the nation’s largest health care agencies?

Suzanne H. Freeman, president of Carolinas Medical Center in Charlotte provided some insights during a recent presentation to business students and others from Appalachian State University’s Walker College of Business.

“We have a really tough job,” she said. “Many of these challenges seem daunting, but I see them as opportunities for creating a better health care environment.”

Freeman said her thoughts most often focus on five areas: the uninsured, health care reimbursements, quality and safety, consumerism, and a qualified workforce.

Freeman said that one in five North Carolinians lacks health care – about 19 percent of the population. “This is a tremendous challenge for us in North Carolina,” she said.

The health care reimbursement system also is a source of problems for administrators, she said. “Health care has one of the must unusual reimbursement schemes that you have ever seen,” she explained “The system pays for (the treatment of) sick people not for the promotion of health and wellness. Some of the challenges that this reimbursement environment has created (involves) capacity issues. If you are sick and ill, finding an in-patient bed is sometimes quite a challenge.”

Freeman said in many cases, hospital and healthcare systems have found they had spent little over the past 10 years on capital improvements and modernization of their facilities. “I think that we will see that trend turn very shortly, as there is already a building boom in our nation’s hospitals.”

She added that constantly changing technology and pharmacology adds a strain to healthcare budgets. “Technology is changing at a rapid rate, one that calls for us to come up with a lot of capital to fund.”

Safety and quality are always a top concern of healthcare administrators, Freeman said. “Ten years ago, the Institute of Medicine predicted that about 100,000 people a year would die unnecessarily in hospitals. Certainly foremost on our minds is how we make our nation’s hospitals safer places and Carolinas Medical Center the safest place of all,” she said.

Today’s patients are savvy consumers, Freeman said, which often times places medical personnel at odds with the patient. “Many times patients think they know far more than the doctors about what they need.”

And not surprising, the lack of a qualified workforce to fill the vacancies created by a retirement is on the forefront of Freeman’s thoughts. “Our nation is suffering from an acute shortage of nurses, physicians and other allied health providers,” she said.

“These are some of the things that plague us as hospital administrators,” she said. “However, I see them as huge opportunities. We can take our business skills and our clinical knowledge and balance them with pragmatism and our compassion for the human being.”