Wisconsin

[MUDPT]

I don't think WI restricted elective procedures (and maybe that wasn't your point) - this is because people didn't want to get them, or the hospitals themselves decided to cut them out.
https://www.facs.org/covid-19/legislative-regulatory/executive-orders

They didn’t, hospitals chose to and it was the right decision. Wife’s salary got cut 10%, waiting on mine, probably at least 15%.

[rocket surgeon]

Both UW Health and Meriter, 2 of the big 3 hospital/medical groups in Madison announced salary reductions for doctors and execs today, plus hour reductions for staff.  Revenue is plummeting from the lack of procedures and lack of COVID patients (the latter is a good thing.)

https://wkow.com/2020/04/21/unitypoint-health-announces-hours-reductions-limited-furloughs-pay-cuts/

https://wkow.com/2020/04/21/paycuts-for-uw-health-doctors-senior-leaders-reduction-in-hours-announced/

my brother works at meriter.  place is dead quiet.  he's starting to squirm a little.  he's been there 25 years.  direct patient care pharmacist

[MUDPT]

my brother works at meriter.  place is dead quiet.  he's starting to squirm a little.  he's been there 25 years.  direct patient care pharmacist

Which floor? I wouldn’t say it’s dead quiet, running at like 40% of normal census wise. It did pick up at the end of the week/ weekend.

[rocket surgeon]

Which floor? I wouldn’t say it’s dead quiet, running at like 40% of normal census wise. It did pick up at the end of the week/ weekend.

ok, probably an overstatement-fair enough.  let's just say he is getting kinda squirmy nervous.  don't know which floor, but works mainly with docs on pre & post surgery stabilizing blood sugar levels along with the usual pharmacy stuff.   i'll ask him and pm you when i find out 

[MUBurrow]

Just bad management.

Prepare for Covid, stock up on PPE for Covid, and then run the hospital as you normally would until it is necessary to restrict non-essential surgery. If, and when that happens, you have everything in place to deal with the virus.

lol you just can't please some people.

[pacearrow02]

Bad management sure in hind sight but based off sensationalized media coverage and dooms day modeling using terrible data I’m not sure they had much of a choice.

Unfortunately it’s not just Meriter and UW caught in a pinch.  Every health system and hospital in the state is finding themselves in a serious bind because of the overreaction to what ended up being a serious problem for only our largest metro areas. 

[Jockey]

Bad management sure in hind sight but based off sensationalized media coverage and dooms day modeling using terrible data I’m not sure they had much of a choice.

Unfortunately it’s not just Meriter and UW caught in a pinch.  Every health system and hospital in the state is finding themselves in a serious bind because of the overreaction to what ended up being a serious problem for only our largest metro areas.

Yeah, I think you are probably right. Lots of media pressure to be ready. But these hospital heads get paid big bucks to make the tough decisions.

[MUBurrow]

Yeah, I think you are probably right. Lots of media pressure to be ready. But these hospital heads get paid big bucks to make the tough decisions.

You would have been screaming for those hospital heads to be in jail if the Wisconsin ERs had looked like New York's.

[pacearrow02]

You would have been screaming for those hospital heads to be in jail if the Wisconsin ERs had looked like New York's.

Of course, with a couple weeks heads up to the potential of what the outbreak could look like if health systems didn’t have a plan in place and repeated the mess of NYC of course they would have been pissed.

I think people can also be justified in their frustration with the overreaction and the consequences that came from that.   Doesn’t have to be one extreme or the other in preparedness, now that we know our health system is on solid footing let’s get back to work while still being smart with keeping high risk/retired folks on high alert and the rest of the population washing hands and working from home if they can.  And for the kids let’s let them have their normal summer sports seasons, activities, camps etc.  This all sense incredibly unfair to them imo.

[Jockey]

You would have been screaming for those hospital heads to be in jail if the Wisconsin ERs had looked like New York's.

My post was, and I quote, "Prepare for Covid, stock up on PPE for Covid, and then run the hospital as you normally would until it is necessary to restrict non-essential surgery. If, and when that happens, you have everything in place to deal with the virus".

So the 1st thing I specifically said was to get all preparations ready for Covid. I'm not sure what your post refers to.

[mu03eng]

My post was, and I quote, "Prepare for Covid, stock up on PPE for Covid, and then run the hospital as you normally would until it is necessary to restrict non-essential surgery. If, and when that happens, you have everything in place to deal with the virus".

So the 1st thing I specifically said was to get all preparations ready for Covid. I'm not sure what your post refers to.

You can't really stock up on supplies and prep rooms for  infectious patients while also consuming those supplies and using said rooms for routine events. Secondarily, you can't free up treatment folks if you need to also those folks to do their primary jobs as if nothing is going on.

[TSmith34, Inc.]

Bad management sure in hind sight but based off sensationalized media coverage and dooms day modeling using terrible data I’m not sure they had much of a choice.

Unfortunately it’s not just Meriter and UW caught in a pinch.  Every health system and hospital in the state is finding themselves in a serious bind because of the overreaction to what ended up being a serious problem for only our largest metro areas.

Once again...

[The Hippie Satan of Hyperbole]

Of course, with a couple weeks heads up to the potential of what the outbreak could look like if health systems didn’t have a plan in place and repeated the mess of NYC of course they would have been pissed.

I think people can also be justified in their frustration with the overreaction and the consequences that came from that.   Doesn’t have to be one extreme or the other in preparedness, now that we know our health system is on solid footing let’s get back to work while still being smart with keeping high risk/retired folks on high alert and the rest of the population washing hands and working from home if they can.  And for the kids let’s let them have their normal summer sports seasons, activities, camps etc.  This all sense incredibly unfair to them imo.

I don't think it was an overreaction as much as it was good preparedness.  Better to be over prepared than under prepared.

And I do agree with you that we should be opening earlier than Memorial Day weekend, but I really doubt you are going to see the normal summer sports seasons and camps.  I would be real hesitant about sending my children to an overnight camp of any sort.

[MUBurrow]

My post was, and I quote, "Prepare for Covid, stock up on PPE for Covid, and then run the hospital as you normally would until it is necessary to restrict non-essential surgery. If, and when that happens, you have everything in place to deal with the virus".

So the 1st thing I specifically said was to get all preparations ready for Covid. I'm not sure what your post refers to.

It refers to opportunity cost.  I get that when you're a hammer, everything looks like a nail.  But this isn't due to some big, bad hospital exec boogeyman. 

Did you know that emergency departments need to, and typically do, run at near complete capacity just to break even?  Even then they are a loss leader for major systems.  What do you think the costs are to, as you say, "prepare for covid"? To you, does that mean just a quick mention during rounds? Maybe a conference call at shift change?  Cmon man.  "Preparing for covid" means moving heaven and earth to create capacity - even creating physical space for atypical uses is a tremendous undertaking in a hospital setting. Plus prepping huge amounts of staff to be redeployed to covid-care supporting roles.  There is redesigning hospital flow to reduce contact between patients, and pre-training highest and best uses for everyone if all of a sudden, 5 days later, you are overrun.  You can't just do that while operating at regular capacity, and it requires you to take your most profitable sectors and and prepare and deploy them as excess capacity for your least profitable.  Tremendous cost. 

And that's just on the business side!  We still haven't pointed out that hospitals are ground zero for covid spread.  So if we take distancing and reducing transmission seriously at all, we can't have hospitals just ignore that to sustain profitability! At the same time as we were rightfully melting down over Wisconsin's election, you wanted your grandma or grandpa going to a major hospital for a pre-surgery consult on Monday, and then returning for their high-revenue hip replacement on Tuesday?  Or you wanted your six year old coming into the hospital for their dermotology procedure?  These are all high revenue procedures that got pushed back, at tremendous cost and stress on the system, to make sure hospitals were as ready as they could be.  Those decisions were made by doctors and other practitioners who had to take that time out of seeing patients, just to push back the next round of patients they were supposed to see.  You don't just delay these things indefinitely - reorienting a tightly booked patient care schedule in a way that doesn't seriously harm patients is a tremendous undertaking that requites a ton of practitioner input.

I'm sorry to be harsh on this, but you don't know what you're talking about. This is the opportunity cost of health care systems getting prepared, and to just lean back and accuse faceless executives of mismanagement is as lazy as you're accusing those hypothetical executives of being.

[mu_hilltopper]

https://www.jsonline.com/story/news/2020/04/22/covid-19-hasnt-spiked-after-wisconsin-election-experts-urge-caution/2997394001/

So .. look .. in non-dysfunctional society, April's election would have been postponed.  We no longer live in that world, so yeah, of course one party used the courts to their (perceived) political advantage and won but lost.  That all happened because of course it happened.  Thanks everyone, great job.

The "good" news out of the April election is that a few hundred thousand people were (forced) into a socio-medical experiment of sorts -- and 99.999% of them appear (for now) to have come out unscathed. 

In terms of socio-medical experiments .. this is fantastic news: We held an event with precautions.  Yes, yes, sure, 19 virus+ people have been linked to the election.   19 of 411,000 in-person voters = .0046%   Even if you triple that number, it's tiny.  Wisconsin is averaging +160 cases per day already.


"Should" the number be zero?  yes.  Would the number be zero if the election was postponed to June?  Absolutely not, as it could not have been 100% mail-in.


I write this because .. we're going to be living with this risk for 12-24-36 more months.   It's not a question of if but when .. when we start doing activities that have a risk north of zero.   -- This debacle of an election?  Showed us some data on how to move forward.

[Frenns Liquor Depot]

"Should" the number be zero?  yes.  Would the number be zero if the election was postponed to June?  Absolutely not, as it could not have been 100% mail-in.

I write this because .. we're going to be living with this risk for 12-24-36 more months.   It's not a question of if but when .. when we start doing activities that have a risk north of zero.   -- This debacle of an election?  Showed us some data on how to move forward.

I totally agree with you.  I was pointing this out somewhere yesterday as well (can't remember if here or another thread since all of these seem to have gone to plaid).  We should use this as a learning and to fortify ourselves for the new normal....and start talking about what do we do in Nov, particularly if there is a re-emergence.

[ZiggysFryBoy]

It refers to opportunity cost.  I get that when you're a hammer, everything looks like a nail.  But this isn't due to some big, bad hospital exec boogeyman. 

Did you know that emergency departments need to, and typically do, run at near complete capacity just to break even?  Even then they are a loss leader for major systems.  What do you think the costs are to, as you say, "prepare for covid"? To you, does that mean just a quick mention during rounds? Maybe a conference call at shift change?  Cmon man.  "Preparing for covid" means moving heaven and earth to create capacity - even creating physical space for atypical uses is a tremendous undertaking in a hospital setting. Plus prepping huge amounts of staff to be redeployed to covid-care supporting roles.  There is redesigning hospital flow to reduce contact between patients, and pre-training highest and best uses for everyone if all of a sudden, 5 days later, you are overrun.  You can't just do that while operating at regular capacity, and it requires you to take your most profitable sectors and and prepare and deploy them as excess capacity for your least profitable.  Tremendous cost. 

And that's just on the business side!  We still haven't pointed out that hospitals are ground zero for covid spread.  So if we take distancing and reducing transmission seriously at all, we can't have hospitals just ignore that to sustain profitability! At the same time as we were rightfully melting down over Wisconsin's election, you wanted your grandma or grandpa going to a major hospital for a pre-surgery consult on Monday, and then returning for their high-revenue hip replacement on Tuesday?  Or you wanted your six year old coming into the hospital for their dermotology procedure?  These are all high revenue procedures that got pushed back, at tremendous cost and stress on the system, to make sure hospitals were as ready as they could be.  Those decisions were made by doctors and other practitioners who had to take that time out of seeing patients, just to push back the next round of patients they were supposed to see.  You don't just delay these things indefinitely - reorienting a tightly booked patient care schedule in a way that doesn't seriously harm patients is a tremendous undertaking that requites a ton of practitioner input.

I'm sorry to be harsh on this, but you don't know what you're talking about. This is the opportunity cost of health care systems getting prepared, and to just lean back and accuse faceless executives of mismanagement is as lazy as you're accusing those hypothetical executives of being.

Boom goes the dynamite.

[pacearrow02]

You can't really stock up on supplies and prep rooms for  infectious patients while also consuming those supplies and using said rooms for routine events. Secondarily, you can't free up treatment folks if you need to also those folks to do their primary jobs as if nothing is going on.

I never argued with the idea that hospitals had to stock up on supplies, reserve entire units (many times multiple units) for COVID patients, and adjust their normal day to day operations for a potential surge.  They might the right move no doubt. 

Time has no shown that we are only using about 25% of our already existing ventilators, ICUs have plenty of room, and hospitals are sinking because of the revenue source that keeps them viable throughout the year is now gone.

My point now is that we are now ready to handle whatever the next 12 months brings us until a vaccine is available so lets get back to normal operations. 

[pacearrow02]

It refers to opportunity cost.  I get that when you're a hammer, everything looks like a nail.  But this isn't due to some big, bad hospital exec boogeyman. 

Did you know that emergency departments need to, and typically do, run at near complete capacity just to break even?  Even then they are a loss leader for major systems.  What do you think the costs are to, as you say, "prepare for covid"? To you, does that mean just a quick mention during rounds? Maybe a conference call at shift change?  Cmon man.  "Preparing for covid" means moving heaven and earth to create capacity - even creating physical space for atypical uses is a tremendous undertaking in a hospital setting. Plus prepping huge amounts of staff to be redeployed to covid-care supporting roles.  There is redesigning hospital flow to reduce contact between patients, and pre-training highest and best uses for everyone if all of a sudden, 5 days later, you are overrun.  You can't just do that while operating at regular capacity, and it requires you to take your most profitable sectors and and prepare and deploy them as excess capacity for your least profitable.  Tremendous cost. 

And that's just on the business side!  We still haven't pointed out that hospitals are ground zero for covid spread.  So if we take distancing and reducing transmission seriously at all, we can't have hospitals just ignore that to sustain profitability! At the same time as we were rightfully melting down over Wisconsin's election, you wanted your grandma or grandpa going to a major hospital for a pre-surgery consult on Monday, and then returning for their high-revenue hip replacement on Tuesday?  Or you wanted your six year old coming into the hospital for their dermotology procedure?  These are all high revenue procedures that got pushed back, at tremendous cost and stress on the system, to make sure hospitals were as ready as they could be.  Those decisions were made by doctors and other practitioners who had to take that time out of seeing patients, just to push back the next round of patients they were supposed to see.  You don't just delay these things indefinitely - reorienting a tightly booked patient care schedule in a way that doesn't seriously harm patients is a tremendous undertaking that requites a ton of practitioner input.

I'm sorry to be harsh on this, but you don't know what you're talking about. This is the opportunity cost of health care systems getting prepared, and to just lean back and accuse faceless executives of mismanagement is as lazy as you're accusing those hypothetical executives of being.

When do you think we can expect clinics, hospitals, etc getting back to normal in Wisconsin?

[Sir Lawrence]

When do you think we can expect clinics, hospitals, etc getting back to normal in Wisconsin?

It's slowly starting.  "Elective" surgeries can mean anything from a hip replacement to an eye surgery to slow macular degeneration.  I've heard that St. Luke's is going to re-start stuff like cataract surgeries on May 1.   

[MUDPT]

When do you think we can expect clinics, hospitals, etc getting back to normal in Wisconsin?

Next week.

[mu03eng]

MCW furloughed 700 people today until at least July

[Hards Alumni]

Will arrests be made tomorrow in Madison downtown since the protest permit was denied?

[ZiggysFryBoy]

Will arrests be made tomorrow in Madison downtown since the protest permit was denied?

No arrests were made during the Occupation, so i doubt any will be made tomorrow.   

[Hards Alumni]

No arrests were made during the Occupation, so i doubt any will be made tomorrow.   

Sorta makes you wonder what the point of permits are if they're not enforced.  I'm curious as to where all these folks think they're going to go to the bathroom.