The chief executives from three major health systems this week outlined how COVID-19 has tested their ability to meet the needs of their patients, communities and the doctors and other health professionals on the front lines of the pandemic.

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Michael Dowling, president and CEO of Northwell Health in New York, said that a plateauing of COVID-19 cases in that system’s 23 hospitals began last week and the number of cases “has started to come down a little bit.” But he added that “our hospitals are still completely packed with COVID patients. Every single bed in our hospital is COVID, pretty much.”

“But the numbers coming in is going down, and the numbers going out is going up,” Dowling said in a panel discussion hosted by AMA Chief Experience Officer Todd Unger. The AMA is providing daily COVID-19 video updates featuring interviews with a wide range of physicians and experts from the AMA and elsewhere who provide real-time insight on the challenge of the pandemic.

“The challenges always are about staffing—making sure we have the right constellation of staff, making sure staff morale is high,” Dowling said, adding that for now access to personal protective equipment (PPE) is sufficient. “But we constantly worry about the morale and the stress that staff are under.”

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Wright L. Lassiter III, president and CEO of Henry Ford Health System in Michigan, noted that the Wolverine State has been near the top in the nation in terms of the number of cases.

He added that Southeast Michigan, where Detroit and its suburbs are, is “clearly being hit the hardest.” The official peak there happened April 10.

“We’re at a place, frankly, where non-COVID patients have a higher percentage of beds in our hospitals than COVID—55% non-COVID. There was a point in time when we were at 80% COVID,” Lassiter said.

As at Northwell, Lassiter said “the most critical issue is supporting our staff and team members and physicians and ensuring that they have the support that they need—certainly emotional and psychological support is one of the most critical issues because, frankly, our staff is dealing with more death than they normally deal with.”

Henry Ford has stepped up its employee assistance program offerings and its chief wellness officer has gone on “wellness rounds” to connect with doctors, nurses and other health professionals to help address their needs.

“We have daily communication with our staff so they understand what’s happening across the system, and know what’s going on,” Lassiter said. “We sprinkle that in with small town halls that help support them without distracting them from the work as well as other communications from myself and other leaders to make sure they know we’re there for them and we have their backs.”

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Susan Turney, MD, is CEO of the Marshfield Clinic Health System, which covers 40,000 square miles where 1 million people live in in rural areas of Wisconsin.

“The dimension of what we are having to deal with is different than other hot spots in the country,” Dr. Turney said. While so far not has hard hit by the spread of COVID-19, the economic impact of the pandemic is another matter.

“We’re the largest employer in the northwestern two-thirds of the state of Wisconsin,” she said. “We know that people depend on us for care, but we also support the businesses in our communities. Look at where we’re at: We’ve had to shut down many of our rural clinics. We’ve eliminated all elective procedures. We also have had to make some really tough choices around our workforce. We have had to furlough or lay off some of our staff and our providers and our senior administrators have all taken big salary cuts to accommodate the needs of the health system.”

The health system’s net operating income is down $70 million, and financial assistance through the $2.2 trillion federal coronavirus relief bill “didn’t cover half of our payroll.”

While Marshfield hasn’t “seen the volume of patients in our hospitals, we have had to prepare for the worst-case scenario and there’s a huge cost in doing that. The cost is something important to do. We want to protect people and providers and make our community safe, but when you look at the challenges of ramping up for this disaster, realizing that your revenue is just not coming in the door, we are really in a survival mode right now.”

“We are really looking to our state and federal governments to help us think about what our future is going to be,” Dr. Turney said. “We’re really critical to our ecosystem in Wisconsin, and we want to make sure that the efforts taking place to fund hospitals and providers takes into consideration the 20% of people in this country who do depend on health systems like ours that were already economically disadvantaged and already in a time of crisis.”

Read this Leadership Viewpoints column by AMA President Patrice A. Harris, MD, MA, to learn more about the AMA’s support for additional federal support for physicians and others in health care that have been hit hard financially by COVID-19.

Learn more: Stay up to speed on the AMA’s COVID-19 advocacy efforts and track the fast-moving pandemic with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization. 

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