PUBLIC TESTIMONY
Testimony by Dr. Joaquin Morante, Pulmonologist at Jacobi Medical Center, on NYC Health + Hospitals Physician Staffing Crisis
2:54:44
ยท
5 min
Dr. Joaquin Morante, a pulmonologist at Jacobi Medical Center, testified about the ongoing crisis in NYC's public hospital system due to physician shortages and recruitment challenges. He highlighted how these issues are negatively impacting patient care, particularly in specialty services.
- Described long wait times for critical services like cancer diagnosis and treatment due to understaffing in pathology and oncology departments
- Emphasized the need for competitive salaries to recruit and retain physicians, particularly in subspecialties
- Criticized the use of short-term solutions like locum physicians instead of addressing systemic staffing issues
Joaquin Morante
2:54:44
Good afternoon.
2:54:46
My name is, good afternoon to all the council members.
2:54:48
My name is Joaquin Morante, and I'm a pulmonary critical care physician at Jacobi Medical Center and a member of Doctors Council.
2:54:54
I completed my internal medicine residency at Woodhull Medical Center in 2016.
2:55:00
Hello again.
2:55:01
And began my career as an attending physician at Jacobi Medical Center in 2019.
2:55:05
As a child growing up in East Harlem, my hospital was Metropolitan.
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I have family members and lifelong friends who currently obtain their care at Woodhall, Lincoln, North Central Bronx, and Jacobi.
2:55:16
I believe that one of the key characteristics of a humane society is its dedication to ensuring that all members of that society have access to quality health care.
2:55:25
The public hospital system of New York has always cared for some of the most marginalized in our communities.
2:55:29
On a daily basis, its health professionals execute its mission to provide care regardless of one's ability to pay and to treat people with respect no matter their race, gender, country of origin, or immigration status.
2:55:44
As a witness to the care that we provided, Jacoby, I can attest that since the pandemic, our public hospital system has continued to be in crisis.
2:55:51
It is in crisis because one of its most important resources, physicians, are now stretched so thin that our patients are suffering.
2:55:57
We are in a crisis that prevents us from recruiting and retaining the necessary physicians to deal effectively with the swell of community members living with chronic disease that was only exacerbated by the COVID pandemic.
2:56:09
This has led to a greater demand for appointments for primary care and specialty services.
2:56:14
The the solution has been to cut visit times to accommodate the growing need for people to see doctors.
2:56:19
Unfortunately, the answer has not been to address the physician shortage by improving recruitment and retention throughout the system and improving staffing ratios.
2:56:28
This is evidenced by the lack of of a negotiated physician contract by the affiliates over the last 15 months.
2:56:34
As a result of insufficient physician staffing, especially in the subspecialties, I'll I'll concentrate on that right now, we have been forced to start to transfer care of our patients to other facilities.
2:56:43
As a personal example, I treat people people with complicated lung disease.
2:56:47
Allow me to finish, please.
2:56:49
That often require that doctors of different specialties collaborate on the care of 1 patient.
2:56:54
At Jacoby, as a consequence of the lack of competitive satellite release, we have been without a rheumatology division for over a year.
2:57:01
This has led us to have to send our patients to Lincoln and Metropolitan, further straining their own patient panels.
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This is not a proactive solution.
2:57:11
This is a crisis management solution.
2:57:14
As a pulmonologist, I'm often asked to perform procedures to aid in the diagnosis of various lung diseases, one of those being lung cancer.
2:57:21
The biopsies that I obtained and my colleagues obtained are then examined by pathologists whose expertise is to discern whether a person may have a malignancy or something that is benign.
2:57:31
Currently at Jacobi, because of the lack of pathologists, it takes approximately 2 weeks, 10 business days, but then you include the weekends, to have a biopsy specimen examined.
2:57:42
Our pathologists are responsible for examining not only specimens obtained at Jacobi and NCB, but also several other h and h facilities.
2:57:50
In order to ensure that the specimens are examined in a timely manner, the solution has been to outsource the work to a private company.
2:57:57
And why is it that it takes so long to be able to provide someone with a diagnosis of cancer?
2:58:01
It's because the Department of Pathology and H and H and its affiliates have proposed non competitor salaries and they've been unable to hire new pathologists.
2:58:09
But to make matters worse, the department of oncology is also woefully understaffed.
2:58:14
I'll finish.
2:58:14
I'll finish.
2:58:15
After a diagnosis of lung cancer has been made, because these are real world examples, patients may have to wait anywhere between 3 to 6 weeks before seeing an oncologist at Jacoby.
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To make this concrete, I do a biopsy today on January 10, 2020 2025.
2:58:32
And that person, that Bronx regs resident will have to wait 2 weeks to find out if they have cancer and another 4 weeks to then get a treatment plan from an oncologist.
2:58:42
They're talking about now being seen at the end of February into March, all the while living with the uncertainty or living with a disease that can end your life.
2:58:53
The inequity is a direct result of the lack of recruitment and retention of physicians to address this massive need.
2:58:59
Instead of providing proactive plan, we have decided to address this crisis with short term crisis management solutions, paying high hourly wage private contract doctors to fill the gaps instead, also known as locum physicians.
2:59:12
Salaried and per diem physicians, a group of physicians that make up 20% of Doctors Council membership, see themselves as part of the solution to helping our communities get healthier.
2:59:21
We are not the problem.
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I'm compelled to speak out when I see a system that is letting down those who it is supposed to care for.
2:59:29
It is up to all of us to make sure that we do not accept less than the very best for our patients, and they should be able to have access to physicians who have enough bandwidth to treat them with dignity and the respect that they deserve.
2:59:41
Therefore, to in summary, I am asking that we come together to focus on recruitment and retention of physicians at h and h facilities by increasing their salaries so that they are at least competitive and not allowing for the erosion of benefits as proposed by the current affiliate contract.
2:59:58
Our communities very much need the services that our public hospitals provide, and our public hospitals very much need the physicians to provide those services.
3:00:07
We're in this together.
3:00:08
Thank you for your time.
Mercedes Narcisse
3:00:09
Thank you.