El Paso Inc.
Posted: Monday, February 13, 2012 10:20 am
Bradley Fuhrman, M.D. By David Crowder
Maybe it’s a pediatrician thing, but Dr. Bradley Fuhrman puts people at ease and exudes the feeling that everything’s OK.
But the months leading up to the opening of the 122-bed El Paso Children’s Hospital and the arrival of patients this week have been crazy.
Just last week there was a major state inspection, before which very little could be moved in and after which everything has to be moved in – fast.
Fuhrman, 65, isn’t tall or imposing in any way. In the world of pediatrics, however, he is a giant.
Yet in the halls of the children’s hospital, people describe him as humble.
The title of physician-in-chief at the new hospital makes him the top doc there. He is also a professor and the head of the Pediatrics Department at Texas Tech’s Paul L. Foster School of Medicine.
His base salary as physician-in-chief is $348,000 and he is paid an additional $100,000 in his capacities as a department head and professor.
Titles don’t impress everyone, including a lot of doctors. What awes them, though, is that Fuhrman is board certified in three pediatric subspecialties – cardiology, perinatal medicine and critical care. He holds or shares patents on 11 medical devices and has patents pending on two others.
And he wrote “the” book on pediatric critical care, titled, appropriately, “Pediatric Critical Care.”
Now in its fourth revision, the 1,740-page text sells for close to $300 and is considered the bible in that specialized field of medicine.
Fuhrman graduated from New York University’s School of Medicine in 1971 and did his residency at the University of Minnesota School of Medicine.
He was critical care specialist at the University of Pittsburgh School of Medicine for six years before moving to Buffalo, N.Y., where he was chief of pediatric critical care at the city’s children’s hospital and professor of pediatrics and anesthesiology at the state university there.
His wife, Lynn Hernan, is also a pediatric critical care specialist. She will teach at the medical school and work at the hospital.
Asked how long he might stay in El Paso, Fuhrman answered, “I have two young children in the house, a 7-year-old and 9-year-old, so it will be a while before they want to move again. And, right now I feel as though I could keep working indefinitely.”
He spoke with El Paso Inc. about bringing more doctors to El Paso, medicine’s role in economic development, and what’s special about this children’s hospital.
Q: The children’s hospital was inspected last week by Texas State Health Services. How did it go?
It went perfect. They liked everything.
Q: Was that the final hurdle before moving things in?
It wasn’t the final hurdle, but it was the essential hurdle to identify it as a fully functional children’s hospital. We’re still in the process of making sure things are set up so the patients will have everything that they need and that everything’s fully functional.
We’re now approved to go ahead with that.
Q: Are there other inspections coming up?
The big inspection will be the Joint Commission, which will come in sometime in the first two weeks after we’ve opened.
Q: So the hospital will be open for business on Tuesday, Valentine’s Day, as planned?
Yes, we’ll open on the 14th.
Q: How many children’s hospitals have you opened like this?
This is the first one.
Q: How is this children’s hospital different from others?
This is a hospital that’s being developed for the children of the area at the wishes of the community that will be a free-standing, separately licensed, that will be not-for-profit and will serve all comers who have need, all patients whether they are well-to-do or uninsured.
We’ll roll out as a completely independent hospital with its own board of trustees.
So those things are really exceptional. The general rule of thumb for the times is that children’s hospitals are rolled into other hospitals or into larger provider systems, which enables them to offer cradle-to- grave coverage. That’s really an insurance issue more than anything else – a business proposition.
This one is purely for the children.
Q: What do you mean by cradle-to-grave in the context of insurance?
Hospital systems become part of provider networks. They sell contracts to employers for their employees that offer them health-care coverage. It’s advantageous to cover the whole family, so they call it cradle-to-grave because it goes from infancy to retirement and beyond.
That kind of coverage is the primary coverage that insurance companies want to sell. So the motivation has been to move children’s hospitals into networks that offer those kinds of services.
In this case, they’ve done pretty much the opposite. They’ve created an environment that will be perfect for children where decisions will be made based on what is best for the children and not on what is best for the corporation or what the needs of adults are.
Q: This hospital is a private, non-profit institution that will be in partnership with a public medical school and a public county hospital. How usual is this arrangement?
It’s very unusual. There are excellent freestanding children’s hospitals in this country. Most of them though either have been rolled into a larger arrangement or are borne into another arrangement.
In this case, they’ve deliberately set out to establish something that is especially for children.
Q: What difference will the Obama administration’s health care reform act make for the children’s hospital if the requirement that everyone be insured survives legal challenges?
I think overall it’s in the hospital’s best interest for everyone to be insured. That will be beneficial in terms of paying for coverage. If you spend $1,000 to provide services to a patient, one way or the other those dollars come out of the funding for the hospital.
So if they’re not funded under an insurance program, then ultimately they will press the hospital to use other resources to cover them. One way or the other, they will be paid for, whether there’s Obamacare or not.
The idea of health-care insurance from a patient point of view is that allows you to get timely treatment so that the patient can receive the best care and come out of their illness in their best condition, able to achieve their potential.
Q: With your expertise and history, you could probably be working anywhere. You were at the children’s hospital in Buffalo. What made you decide to come here?
It was the opportunity. This is a time when amazing things are happening to El Paso. You’re getting a full-blown, four-year medical school, which will bring new doctors to the residency program and to the community. You’re getting a new children’s hospital that will raise the bar for health care all across the city of El Paso.
Whether people come to the children’s hospital or not, it will improve the care of children all across El Paso.
It’s a wonderful opportunity; I couldn’t resist it.
Q: Tell us about some of medical devices you’ve created that are used around the world.
Probably the best-known thing that I have worked on is a catheter for draining fluid from around the lung or the heart and that can present as a life-threatening problem.
I developed that more than a decade ago, and it’s been heavily utilized and now benefits a very large number of patients every year. That’s been very rewarding for me.
It grew out of my clinical work. So it’s an example of what can happen when a person in an academic practice has the time to turn their ideas into something that can service a wider population base. It’s the kind of technology development that the children’s hospital will promote for this area.
Q: Do you think this kind of setting will attract research, medical device manufacturers and pharmaceutical companies?
This should be attractive. It’s going to be a large, new enterprise. There are people here interested in promoting new developments in health care and there are people who are interested in investing in it.
There’s synergy with Juárez because Juárez is an excellent site for manufacturing and El Paso is an excellent site for prototyping and for development of new devices. So there are good reasons to consider a location like this.
Q: How long might you stay with the children’s hospital? Are you making a long-term commitment?
I would probably stay here until I retire, provided this moves forward and is successful. My contract is a four-year contract, I believe. I would certainly fill out this four years and probably another four years if that looked like it was good for both me and the area.
Age has a lot to do with how your own health is and how you feel. I have two young children in the house, a 7-year-old and 9-year-old, so it will be a while before they want to move again. And right now I feel as though I could keep working indefinitely. So I’m not planning to retire any time soon.
Q: Some members of the medical community are concerned that the pediatricians and specialists who have been recruited will leave when their contracts are up. What do you think?
I’m new here, so I don’t have a real insight into that. But I’m hoping in the development of the pediatric department that people would want to be here long term to help develop their careers, the department and the services for children. I don’t see it as a short-term venture.
Q: Another concern is that the salaries for these new doctors are too high and may be unsustainable in the long run for a hospital that doesn’t have tax revenues coming in. Does that worry you?
I don’t think that this medical school or this hospital is offering salaries that are greater than the salaries you would find at other hospitals in the area.
Our effort right now is to get the best people for the needs of the community, and the fact that we’re recruiting for a hospital that hasn’t opened its doors does mean that we have to make a somewhat greater investment than we will have to make five years from now in terms of recruitment. But we’re not above market for El Paso.
Q: More pediatricians and specialists will mean fewer children leaving El Paso for treatment. What areas will still require out-of-town trips and how do you see that changing?
There are a large number of reasons to leave El Paso right now to get health care and we think we can eliminate most of them. A good example is cardiac surgery.
There is not a pediatric cardiac surgeon in El Paso. There should be a pediatric surgery program, but that will take years to develop because all of the infrastructure that you need to have.
Q: Other examples?
Neurosurgery. But we may eliminate the need for a child to leave for neurosurgery within the next several months. Gastroenterology, perhaps, by July. In oncology, we’ve already eliminated the need to leave El Paso for pediatric oncology care.
We think that we will hire perhaps four dozen subspecialists in various areas of children’s care over the next year. It depends on who you find and who you can entice to come live here.
But we’ve just recruited four pediatric anesthesiologists who can keep a child comfortable and alive during complex operations despite the fact that they have a small airway and childlike or infantile reflexes and cardiovascular system.
There are no other pediatric anesthesiologists in El Paso, a city of almost 800,000. So this is a big step forward. It’s infrastructure. It will make it possible to do neurosurgery, cardiovascular surgery and general pediatric surgery with greater safety.
Q: Has your presence here and your reputation contributed to the hospital’s ability to recruit additional physicians?
Recruitment is moving forward, so I suppose I would take some credit for it. But I’m certainly not the centerpiece of it.
The centerpiece is the new hospital. The new hospital is bringing more bang for the buck into this community than anything I am aware of for the last 50 years.
It will be very attractive to physicians who are mission driven and want to provide services to children.
Q: What impact will the children’s hospital have on economic development in El Paso?
It will create good jobs, not just for physicians, but also for people who are taking care of children, such as pediatric nurses and pediatric technicians of one type or another.
It will create opportunities for entrepreneurial advances. It will be attractive to employers bringing in young people for good jobs who require that their children have a good place to go when they get sick.
It will be an engine for economic development in El Paso and the region. The money spent on health care at El Paso Children’s Hospital will mostly go into salaries.
And that money will go through the system again in El Paso, and you will see it in the department stores and grocery stores.
Q: How does it feel to be a part of the opening of this hospital?
It’s a marvelous opportunity because so much is going to happen that will benefit the children of the region.
I couldn’t ask for a better way to finish my career.
E-mail El Paso Inc. reporter David Crowder at firstname.lastname@example.org or call (915) 534-4422, ext. 122 and (915) 630-6622.