Mayor Megan Barry revealed a plan on Thursday to entirely restructure Metro General Hospital. She called an announcement that Meharry Medical College was moving its students to another facility an "opportunity to revisit" the business model of General Hospital.
The facility has been in financial trouble for years, and the city has pressured it to create a sustainable model and attract more paying patients. Barry says that hasn't happened. In recent years, the hospital has barely made payroll, much less launch a marketing campaign.
"It's not a lack of leadership," she told students and professors gathered in a Meharry auditorium. "But Nashville is a vibrant market."
She blames the intense competition between Vanderbilt, Saint Thomas and HCA — which treat many more uninsured patients than General Hospital, despite its mission to provide indigent care.
"I want people to have access to health care, and I think it's great that in Nashville, we have access to great health care. So that continues," Barry said. "The good news for citizens of Nashville is they have lots of choice."
The details remain fluid, but Barry says she will propose additional funding to help General Hospital get through the year and begin to wind down. Then she envisions the organization running outpatient clinics — places where people might get check-ups or help with their insulin. Those kinds of visits, which don't require an overnight stay, currently represent roughly 90 percent of the patient load. The city would establish an indigent patient fund to help with unpaid bills at private hospitals.
Already, workers are asking what will happen to their jobs. One approached Barry at Thursday's announcement, questioning why the plan has been kept secret from employees.
The hospital authority's leadership is not showing public support. None of the top management appeared at the event.
"They know about what's happening," Barry said. "They absolutely understand the financial situation that Metro General is in."
Meharry Students Move To HCA
The impetus for the big shift is Meharry's decision to train students across town at Southern Hills Medical Center. School officials call the agreement with a hospital owned by Nashville-based HCA a "historic" milestone for the institution, which specializes in training physicians of color.
Right now, Meharry students spend their third and fourth years at General Hospital, which is on Meharry's campus in a tower owned by the school. But because business is so slow at the cash-strapped facility, operating at one-third of capacity, Meharry has to send most students to other hospitals around the region to get the necessary experience to become a doctor.
At this point, Meharry is not planning to move from its current North Nashville campus. But president James Hildreth says having all his students at one site, run by the largest investor-owned hospital chain in the country, is a step up from the current situation.
"We're committed to the community, committed to the patients," he told reporters Thursday. "But my first responsibility — and the most important one I would say — is training future generations of physicians."
HCA, a for-profit enterprise, owns other medical centers that are considered teaching hospitals, like Tulane Medical Center in New Orleans. In all, an estimated 3,000 medical students are already working in HCA facilities around the country.
"If we can be part of educating physicians for the future, we want to be a part of that," CEO Milton Johnson said. "It will also help solve a physician shortage for HCA in this community down the road."