Medical Center officials have begun to look into restructuring approximately 150 jobs in discharge planning, which will affect mostly social workers and nurses in Duke Hospital.
Although the hospital regularly conducts internal reviews of its employment structure, the move also comes in response to the crunch from the Balanced Budget Act, which will take $100 million out of the hospital in a five-year period.
"We look on a routine basis at all jobs throughout the organization," said Mike Israel, CEO of Duke Hospital.
Employees affected by the restructuring will have the opportunity to move to other areas of the Health System, including Durham Regional Hospital and Raleigh Community Hospital.
The Medical Center is in the beginning stages of the restructuring process, which was announced at a general meeting several weeks ago.
Senior administrators in charge of particular areas of the hospital met with employees to answer questions and address specific concerns.
Gay Bonds, a social worker in general medicine who works in the inpatient unit, said some of her colleagues are concerned about the uncertainties surrounding the potential restructuring.
"It's a scary thing for a lot of people, especially if you have a family to worry about," she said.
However, Bonds said she is not terribly worried about the restructuring process. "I've been a social worker for so long, I pretty well take everything in stride," she said.
Recent revisions to Medicare have made it necessary to distribute resources differently, Israel said.
"The needs of health care change [and] technology changes. If we don't react, we are going to be in big trouble," he said.
"The environment is much more difficult," he continued. "We've got to make it on our own, and we are responsible for our own destiny."
Academic health centers around the country have been feeling similar pressures to restructure and make appropriate changes to resource distribution as a result of the federal Balanced Budget Act, which decreased the annual Medicare payments to teaching hospitals.
In total, academic health centers will lose $14.7 billion of an expected $122 billion by the expiration of the bill in 2002.
Several prestigious institutions nationwide have lost a major amount of funding.
For example, in the past two years, the Georgetown University Medical Center lost approximately $120 million, according to an article from The Chronicle of Higher Education.
Duke Hospital, which is losing $100 million in five years, finds itself in a better position than several of its counterparts.
Israel said that although 150 jobs are in the process of being reviewed, he does not expect that all will be affected by the restructuring process that will occur.
Israel added that presently the hospital has 850 out of 7,000 positions available. Therefore, he said, opportunities exist for those who potentially will be affected by any changes.
"It's certainly not going to be 150 [jobs affected]," he said. "Theoretically, it could be zero."
Medical Center officials will work closely with any hospital employees who are affected by the restructuring, and Israel said that he does not expect any layoffs to occur.
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