Really Scary Testimony from Your County Legislature

If you don’t like the medical care you’re receiving in Central New York, you have but one place to look for the problem:  “About 75% of the doctors in this region are from Upstate Medical University . . .”

The minutes of the July meeting of the Health Committee of the Onondaga County Legislature are posted at   Dr. David Smith, president of Upstate, testified. 

Upstate is the biggest employer in Onondaga County and has a budget about equal to that of the entire county government.  Most of us either work for County Executive Joanie Mahoney or President David Smith.

For your convenience, here is Smith’s testimony.  If you start with the premise, as many of us do, that our medical care sucks then this is really scary stuff.  Read it and weep.




MEMBERS PRESENT:  Mr. Laguzza, Mr. Meyer, Mr. Holmquist, Mrs. Ervin

Dr. David Smith, President, Upstate Medical University

Dr. Smith congratulated the Legislators on passing the local law prohibiting smoking within 100 feet of the perimeter of property operating as a general hospital.  It has made a difference, their own commissioned peace officers and others have found it easy to work with and they have found incredible compliance.  Dr. Smith provided a map of the Upstate Medical University buildings (on file with Clerk) and noted the following:

  • East Tower of Upstate Medical University:  $150 million expansion to University Hospital, no state dollars in this facility, entirely bonded. 
  • Total budget for Upstate Medical University is $1.15 billion, 8,000 employees (added 442 employees this year).  State funding is only about 10.1% of their entire budget.
  • Hospital side:  Trauma center for 17 counties from Canada into Pennsylvania; burn center for 32 counties, poison control center for 34 counties, telepsychiatry for 38 counties.  Budget is a little over $600 million; only 6.2% of the budget comes from the State of New York.
  • They are a private university with a public mission regulated like a state agency.
  • Mission:  teaching, research and service – it is a university with a hospital attached.  They have a campus in Binghamton, opened a set of classrooms at Jefferson Community College in Watertown and have affiliations throughout the region.
  • Vision:  to be the finest regional academic health center in the country.  They need a larger footprint to do that (now landlocked).
  • Noted the addition of Kennedy Square where they are building a biotech center ($22 million), taking possession of Townsend and Harrison Towers this week.  Towers will be renovated for student/resident housing ($16-17 million).
  • Multi-dimensional growth – to be regionally responsive – growing enrollment (about 30%), growing research mission (19% this year), and being able to meet other degree needs such as their new nurse practitioners program and psychiatric health.  Post traumatic stress and other things at Ft. Drum are creating tremendous demand on the region.
  • Budget is driven predominantly by patient revenues, federal grants, research grants, private industry relationships, tuition which is less than 8% of their budget (a little over 1,500 students); also have about 500 medical residents.  About 75% of the doctors in this region are from Upstate Medical University, about 90% of nurses stay in three county region (almost 100% in five county region).  College of Health Professions: medical technologists, respiratory therapists, radiation therapists, perfusionists (heart/lung machine operators) – almost 89% stay within region.
  • Had to offset substantial reductions of state support (almost 16% on the university side and about 18% on hospital side) – realized 16% growth in clinical revenue this year, research goal was 10% – realized 19% this year.  They do about $40 million worth of research per year; National Science Foundation suggests for every million dollars of research, it produces 27 new jobs.

 Dr. Smith noted that if they want to continue to grow and meet their mission and anticipating that there will be further state cuts next year; they will have to have capacity.  Currently, the hospital is running 95-96% occupied.  If they are going to continue to hit the mark of 5% annualized growth, they will have to have access to additional beds, also need to look at new ways to train (working with the private sector).  They have submitted a proposal regarding a partnership with Community General Hospital because of their concern about regional services and the Berger Commission requirements for Community General, Van Duyn, Auburn and Fulton.  According to their strategic plan, they need access to about 110 additional beds.  With enrollment and faculty growth, they will need approximately 540 total bed access.  Community General has about 306 licensed beds, staffs about 100 to 130 at one time.  If Upstate were to build 100 new beds, it would cost in the range of $85-$90 million and then would have to get a certificate of need.  Considering Community General’s debt, pension obligations and assets, Upstate is looking at a substantially less cost per bed and Community General has the certificate of need.  It is an area where they could do more teaching and grow and expand their Family Medicine, also have interest in looking at Acute Mental Health needs.  Upstate has a long-standing relationship with Community – has run the emergency room at Community General for several years under contract and also their rehabilitative medicine program.  They are seeing more regional requirements for their graduates and on the revenue side it makes great sense.  Concerning jobs in the area, there are 1, 0000 positions at Community General and there is 42 acres of land.  They are beginning to have some dialog with Van Duyn concerning partnering with them because of their interest in long term care and other aspects of care of an aging population.

 Mr. Warner noted that their budget is about equal to the entire County budget.  Dr. Smith said their goal is not to go in a disrupt a lot of things, they are primarily here as a university, what drives their mission is education and research, would create more synergy than anxiety and should stabilize all the entities.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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1 Response to Really Scary Testimony from Your County Legislature

  1. arleen fordock says:

    Thank you Ms Woodlen! The speech of Dr Smith is very enlightening to me personally. The aim of Upstate, per Dr Smith,
    is to acquire some of Community General’s beds and operate a “mini-upstate” at Community General Hospital (south of
    Syracuse). It is no comfort to me that Dr Smith mentions nothing of “updating” the present X-ray rooms for currrent
    patients going to Upstate for testing (to resolve via those x-rays what is wrong with the patient). It was my sad experience
    to be a patient (unhospitalized-type) this year, having severe gastroentestinal history, at Upstate’s “x-ray” room. Due to
    strictures, etc, my ability to swallow the radioactive liquid was too slow so the technicians had to leave me out in the hall
    in my gown until some liquid had flowed to proper parts of “gastro” system to enable more xrays to be done. Took about
    4 of these pauses til the liquid got to where it was in proper area of my body. Meanwhile a throng of patients waited their
    turn, and did get a turn to be x-rayed (about 4 people were done while I waited in hallway). My question: if there’s all
    kinds of monies(bonding) for Upstate, then why hasn’t Dr Smith talked of increasing patient rooms and “ante-rooms” for
    patients to NOT sit in a hallway (in their gown)????? My other experience, on that same day, was relating to comfort of
    the patient while on the x-ray table. Due to much damage to my nerve system (surface type nerves) my area from hips to
    knees is terribly painful while ON the x-ray table and “flipping” myself at least 8 times into the positions required by the
    lab technician(in order to accomplish clear x-rays) was voiced by me.
    No amount of my voicing this painful feeling was considered important
    enough for them to offer me the “egg crate/sponge” to put under my body. I did not see this sponge item hanging on the
    doorknob(back of entry door) until AFTER I’d been moving myself in pain on the xray table. If I could visit with Dr Smith, with all his insight and desires for UPSTATE, would he consider the patients’ needs in future? Does he have a oath to
    provide for patients as well as for the teaching functions of his staff? Going to Upstate for any more future testing is not
    what I will do. At other xray facilities in Syracuse I’ve not had the painful experience that was mine at Upstate. Will
    appreciate others who read this response of mine, to now also tell Ms Woodlen of their experiences at Upstate when a patient. Maybe a quantity of patients will expound actual occurrences to appeal to Dr Smith spending monies on the patients’ needs. One can only hope for better cooperation with patients at Upstate. Wishing for consideration of patients. I am on Medicare AND a enrollee in secondary coverage (so there is NO lack of payment to Upstate).

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