There’s a lot of uncertainty facing healthcare in the COVID-19 era and Intermountain Healthcare is poised to weather the storm. Marc Harrison, MD, Intermountain’s president and CEO, recently addressed concerns over provider compensation, how Intermountain is positioned to support the community, and why we need bold action regarding social distancing.
QUESTION: Can you clear up any confusion about a news story that was published that we're cutting pay for physicians, advanced-practice providers, and nurse practitioners?
MARC HARRISON, MD: Yeah, this was a really unfortunate story and it's in my experience, really atypical for journalism here in Salt Lake City, Utah.
Intermountain hasn’t cut anyone’s salary, not a single person's. And in fact, the leadership team has been working with leaders across the organization to try and understand in this extremely turbulent time how we keep people safe and how we take away anxieties around not just their physical safety, but their economic stability as well.
To that end, we've got a lot of things going on. If you take our non-physician advanced-practice caregivers, we've provided people with up to four weeks of administrative time, so if they're not getting their hours, there's a nice cushion there. We're allowing people to go through their paid time off and then we're actually allowing people to go negative into their paid time off by another 80 hours. And we will keep evaluating.
Our desire is for people to feel safe and secure and not need to worry about making their mortgage or their car payment.
We're also doing some really super creative stuff like redeploying caregivers. To that end, more than 2,600 — so that's about three large companies worth of people — have been redeployed at one point or another in Intermountain. We're looking for opportunities for people to be able to do meaningful work. It helps themselves, helps their neighbors, helps their communities, at a time that's really, really tough.
I'd like to address this whole physician/advanced-practice provider piece as well. So if the headline that was written the other day would have been accurate, it would have said, "Intermountain is protecting physicians and advanced-practice clinicians from potential economic downsides due to loss of volume from COVID-19."
So many of the people who are listening to us are realizing, and this is very appropriate, folks are staying away right now for certain things. We've canceled elective surgeries. We want to save our personal protective equipment, we want to maintain capacity. It's all good, but we know that has a negative impact on some of our providers. So of our 2,600 employed doctors and advanced-practice providers, we think that roughly a third to a quarter of them have risk in terms of how their contracts are written because they're activity-based contracts. The busier you are, the more money you make. And they have contracts that are written in such a way that if their activity goes down, they could get paid less money.
What we've as a leadership team decided to do, and we worked on this for weeks and weeks, is to try and blunt that. To try and make sure that nobody ever makes less than 85% of their base salary. Now, is that perfect? Probably not, but it's a responsible move that should keep people in their homes, in their cars, able to pay their kids' tuitions. And we feel really pretty proud about that.
QUESTION: So how are we preparing as a company for this potential surge that could be coming with COVID-19?
DR. HARRISON: Well, no one would ever wish for this situation. It's very scary and people will die. People have died. Yet it is an opportunity for us to come together in extraordinary ways. And what I'm seeing is people stepping up as leaders, either unofficial or official leaders, with creativity, innovation, thoughtfulness, crossing traditional silos, making decisions very fast. So there's a super-organized structure that we follow on a daily basis and there are work streams around personal protective equipment and surge planning, in supply chain, and all sorts of things.
So in a tough situation, I can't think of anybody who's better prepared than we are. Still lots of work to do around improving testing, having much more specificity around how many people we think are going to come through, and then matching that with equipment. But boy, I'm really glad I'm living right here in Utah. I'm glad that my neighbors are Utahns. I'm thrilled for the community spirit that we're seeing, and we're going to do absolutely as well as anybody would do with this situation.
QUESTION: What counsel and guidance do you have to community members to help them prepare and lessen the impact of what we could potentially see in Utah? What would you tell your neighbors they could do to help lessen this impact on our healthcare system?
DR. HARRISON: I would tell my neighbors, Zoom me, don't visit me. Right? We know that bold, aggressive, social distancing really works. Pay attention. I know you love your families, your extended families. Now is not the time to have a family reunion on a Sunday afternoon. I would pay really close attention to symptoms and if they pop up, get tested and get tested appropriately, and follow the rules. It's easy to think, "Oh, I won't be the person who infects a dozen other people." But all you have to do is look at the news and you hear stories about reunions, parties, etc., that turned into absolute disasters.
The other thing I'd say is young people are not immune to the consequences of COVID-19 either. And so even if you're young and healthy — not old and decrepit like me — pay attention, take good care of yourselves. We need you healthy to help the rest of society and we don't want you getting really sick, which you could.
QUESTION: In terms of the whole concept of social distancing, people need to remember they can still communicate with their friends and family. It doesn't have to be social distancing; it can be physically distancing and making sure you're still interacting with someone virtually and connecting with people without actually seeing them in person.
DR. HARRISON: I'm really glad you mentioned that. I'm very much in favor of Governor Herbert's Stay Safe, Stay Home program, and he really emphasized the difference between social distancing and physical distancing, and let's stay close socially and interpersonally. And we're really lucky; we've got great tools to do that, but let's stay apart, and let's use really good hand hygiene and let's be patient. This is a marathon, not a sprint, and we're going to be okay.
QUESTION: What is Intermountain doing specifically for our caregivers to help them stay healthy and safety throughout this time?
DR. HARRISON: So for our caregivers, we’ve provided lots of education around how you put on and take off personal protective equipment. We’ve invested enormous amounts of effort looking at quantities of personal protective equipment across the system, how we develop backup plans to make sure that continues even through the busiest times.
And I guarantee you, we will have moments when things aren't perfect, but I also will guarantee you that our people are thoughtful, innovative, creative, and really dedicated. They're going to have figure it out and we're going to figure it out with them.
The other thing we're doing that I think is very helpful is we've developed a digital symptom checker. Now more than 100,000 people have used it and it allows people to figure out whether they need to be seen or not in order to get a COVID-19 test. It allows them to self-screen and allows them to stay safe and stay home unless they really are at high risk.
QUESTION: Besides that symptom checker, what are some other things we're doing to help people?
DR. HARRISON: Right, so we're offering superb medical care and I do want to emphasize that if somebody is truly ill they still can be seen in our InstaCares. We don't want people to suffer or to experience a serious medical event without getting care. I think between telehealth and the InstaCares, we can find a very appropriate place for you to be seen and stay safe. I think that's absolutely key.
We also are doing a good job of providing lots and lots of information. People learn in different ways. And so whether it's hard copy or digital or video, I would really encourage the community to engage with us and then ask questions. We're here to treat, but as much as anything, we're here to educate and support as well, and look forward to helping the community.
QUESTION: What about people with a variety of other health conditions? What should they be doing right now?
DR. HARRISON: They should be taking care of themselves. I think they should speak with their provider and they should determine an optimal treatment plan for them given the overall context.
I'll give you an example. I had labs drawn at 7 this morning for my cancer. It's really important to have done. I wore my mask, I washed my hands, I got in early, I got out early. In the grand scheme of things, I need to stay healthy for my family and for me, but also to serve others. And whatever minimal risk there was, was absolutely worth it.
Intermountain's working really hard to have safe, clean facilities with knowledgeable, thoughtful people who are working in them with the right personal protective equipment. So please don't suffer in silence. Whether it's your arthritis or your GI problems, whatever — please, please get help. And we have a whole new suite of tools including lots of telehealth tools that will allow us to serve people. Many can actually get that ongoing maintenance care without ever leaving their home.
QUESTION: Is there anything else you'd like to tell us today? Any last remarks you'd like to make?
DR. HARRISON: I think the last thing I'd like to say is this is a generational event and it's super real. I had a talk this morning around 7 a.m. with one of my oldest and dearest friends. He's an anesthesiologist. He lives up in Idaho. And he called me to tell me that he had a meeting at the surgery center where he works, where he's worked for the last 20 years. And people came in and told him that they were being shut down and he was out of work. So he's 58 years old, hardest worker I know. Unbelievably talented person and none of this stuff that we’ve done in terms of trying to soften blows keep people in the workforce. He's out of work. He's a really resourceful guy. I think he's going to be okay, but he's scared. And I'd ask that everybody who's watching this, you probably know somebody just like that.
Let's have empathy in our hearts for other people. Even if they look okay, they actually may not be okay. So I'd say take that moment and ask people how they're really doing with a pause to really listen and see how we can help each other. It's going to be more than curing people with COVID-19. It's going to be more than putting the economy back on the rails, which we are going to do both of those. The question is what is our society going to look like afterwards? What good things are we going to learn about interacting with each other? I for one am very optimistic.