[caption id="attachment_43849" align="alignleft" width="198" caption="Gary Greensweig"][/caption]

Family practice physician Dr. Gary Greensweig is currently the chief medical officer for St. Jospeh Health System-Sonoma County, overseeing medical operations at Santa Rosa Memorial and Petaluma Valley hospitals, as well as numerous outpatient and mobile clinics. He has practiced as a primary care physician in Santa Rosa since 1979.

He was the founding medical director of the Santa Rosa Memorial Hospital Mobile Health Clinic and served in that role between 1991 and 1998.

Dr.Greensweig, who will be a panelist at North Bay Business Journal's Health Care Conference, recently shared some of his thoughts with the Business Journal:

Q. As chief medical officer of St. Joseph Health System-Sonoma County, what is the biggest challenge faced by your industry in terms of providing care at a major hospital, and how is St. Joe’s addressing such challenges?

A. The St. Joseph Health System has a 61-year history in Sonoma County of providing care to our community.  During that time we have seen the number of unfunded and under-funded patients for whom we care grow exponentially.  We believe that there needs to be an equitable system to assure that all health care facilities share in the “financial burden” of providing care to these patients.  We welcome the responsibility to care for all of the members of our community; however, we believe this is a responsibility of all major hospital systems that must be shared equitably.  Not to do so threatens the missions of all of the hospital providers.

Q. How do you see the federal health reforms impacting the medical side of health care, and not just the business side?

A. We believe that health care reform “pushes” us in the right direction as it relates to caring for our community. In terms of the medical side of health care, we are being asked to take care of large populations of patients as a group and demonstrate greater accountability for their longer-term health and clinical outcomes. This moves us from providing episodic care to more longitudinal care. We see this as a very good model – a model that is completely consistent with our mission.

In addition, we agree that all patients should have access to health care and health insurance coverage, and applaud the stipulations in health care reform that help bring this vision to reality. At the same time, national health care reform has and will place tremendous cost pressures on us and the rest of the health care system. Yet there does not appear to be any relief to the number of unfunded regulatory and accreditation mandates that are asked of hospital systems.

Q. As the region’s trauma center, what challenges are associated uniquely with that?

A. We are very proud of our level II Regional Trauma Services Program. It’s a responsibility that we take seriously – as evidenced most recently by our commitment to move forward with a $15 million expansion and renovation of the emergency department and trauma center facilities at Santa Rosa Memorial Hospital. We maintain a state of continuous readiness including specialized physicians, dedicated emergency and operating room staff, and facilities so that we’re equipped to immediately meet the needs of critically injured patients in a five-county area. The program literally saves the lives of our friends and neighbors each day. Maintaining the Trauma Program is expensive. As the number of unfunded and under-funded patients who access the trauma program grow, and cost pressures rise as it relates to national health care reform, it places new demands on us and the community to do our part to help sustain and support this vital community resource.

Q. What efforts is St. Joseph undertaking to recruit and retain physicians to its system and Sonoma County?

A. We are working closely with the medical staffs at both Santa Rosa Memorial and Petaluma Valley hospitals to stabilize both the primary care and specialty community of local physicians. The Annadel Medical Group, to which I belong as a family medicine physician, currently has 44 providers and we continue to add new clinicians. We are working on a number of relationships that bring together the talents of both primary care and specialty physicians to focus on maintaining quality in a more integrated way.  We have several new recruitments under way or recently formalized in key areas of community need for specialty services. We also are working with the Marin-Sonoma IPA, along with our district hospitals, to assure their viability in meeting the needs of those in more rural areas of the county. Finally, we are committed to providing care for patients along a continuum that includes clinic or outpatient care, inpatient care, home care and hospice.

Q. Could the possibility of more people obtaining insurance by way of health care reform positively impact St. Joe’s, as it  provides care for a very significant portion of the region’s uninsured?

A. In general, we welcome incentives within national health reform which will expand the number of individuals who have health insurance. However, if the “universal coverage” requirement leads to more individuals whose treatment is underfunded because their plans don’t adequately cover the costs of their care, then we could experience an ironic downside. Namely, more patients may be shifted into the ranks of the under-funded, which will compund the pressure on hospitals to care for all who come into our care, regardless of their ability to pay.