February 21, 2025 • 40 mins
Earlier this month Mass General Brigham hospital system announced its largest layoff in the organization’s history, with an anticipated 1,500 job cuts. What are the implications for patient services at MGB? The two phased layoff comes at a time the country is facing a nationwide physician shortage. According to the Association of American Medical Colleges, the U.S. is facing a shortage of up to 124,000 physicians by 2034, including 48,000 primary care physicians. Dr. John Freedman, a health care expert joined us to discuss.
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Episode Transcript
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Speaker 1 (00:00):
It's night Side with Dan Ray on WBZ Costin's Radio.
Speaker 2 (00:06):
Thank you very much.
Speaker 3 (00:07):
Al As we move into our nine o'clock hour tonight,
it is about nine oh seven. My name is Dan Ray,
host of Nightside, and we're going to talk about the
Mass General Brigham layoff, largest layoff in its history, amid
ongoing restructure.
Speaker 2 (00:25):
This story broke in early.
Speaker 3 (00:28):
February, mid February runs the ninth or tenth of February,
a couple of weeks ago, well yeah, about ten, ten
eleven days ago, and the subheadline of the Globe article,
written by Jessica Bartlett, was facing rising costs and hoping
to make it sprawling network more efficient. The state's largest
private employer aims to cut payroll costs by over two
(00:51):
hundred million dollars MGB. Mass General Brigham employees approximately eighty
two thousand people, and they intend to save at least
two hundred million dollars annually.
Speaker 2 (01:07):
So these are big numbers.
Speaker 3 (01:08):
Okay, two percent of its salary and benefits cost. That's
sort of the big picture for you and me to
understand that we have brought into the conversation tonight doctor
John Friedman, who not only is a physician doctor an MD,
but he also has an MBA. He is a graduate
(01:28):
of Harvard, University of Pennsylvania School of Medicine, and the
University of Louisville School of Business. Doctor John Friedman is
a healthcare leader CEO of Freedman Healthcare, LLC. Doctor Freedman,
Welcome to Nights Ott.
Speaker 4 (01:44):
How are you doing well, Ben, Thanks for having.
Speaker 3 (01:47):
Me well, Thank you very much for joining us. This
was a blockbuster story in my mind. Am I overstating
that when an institution as important Mass General Brigham is
to our community announces layoffs and cuts as draconian or
(02:11):
dramatic as this.
Speaker 4 (02:14):
I'm going to say. I'm going to say yes and no.
It's note worthy because this is certainly an unusual event.
But in the scheme of things, it's no secret that,
you know, mass General Brigham is the most expensive hospital
network in Massachusetts. They are also the dominant network in Massachusetts,
and they've been under a lot of pressure to get
their prices down, frankly, and it hasn't happened. So, you know,
(02:35):
the state and private employers have been trying to get
them to reduce their prices, and this might be actually
a beneficial sign that they're tightening the belt. Apparently these
cuts are to non clinical positions, to administrators, and maybe
this is all a good thing. At the same time, Dan,
(02:55):
I think you may be onto something that you know,
it's concerning that this is by are the richest. I've
got very deep pockets. They're a very wealthy organization. You know,
they're needing to cut What does that mean for the
rest of the Massachusetts health ecosystem, especially in the wake
of the debacle that is Stuart Healthcare and what we're
dealing with the fall out there.
Speaker 3 (03:16):
Yeah, we have Stuart Healthcare. We have a number of
sort of undercurrents in this pool. If we think of
the medical health care system sort of.
Speaker 2 (03:25):
As a pool of water.
Speaker 3 (03:27):
We may not quite see it on the surface yet,
but clearly you have the Stewart dilemma tragedy and the
loss of at least a couple of hospitals, who knows,
maybe eventually more. You also have a dearth of PCP
personal care physicians. It's tougher for people to get a
doctor these days anymore, and I think that probably a
(03:52):
lot of people who normally might have a physician who
they would go to now can't get a physician and
they end up at emergency rooms or just going to hospitals.
So I think there's some trends underwater that I want
to look at. I want to read one paragraph to
you and have you interpreted for me from the Boston
(04:13):
Global article by Jessica Bartlett of February tenth, which is
a really good article by the way.
Speaker 2 (04:20):
She wrote.
Speaker 3 (04:21):
Studies of Mass General Brigham's management structure also revealed that
Mass General Brigham had more managers per frontline worker than
industry benchmarks, duplicative management roles, and many layers of managers.
Executive said, while high performing organizations may have maybe seven
(04:43):
or eight layers of management between the frontline worker and
the CEO, in some places at Mass General Brigham there
were fifteen layers of management. How does any business function
with fifteen layers of management or mid management.
Speaker 4 (05:00):
I think the short order is it's really hard to
And I think a reality is that when healthcare organizations merge,
they will always put out public statements about how they're
going to get efficiencies of scale. Economies of scale, they're
going to save money on accounting, on purchasing equipment, they're
going to be able to do all kinds of things.
(05:21):
There are also dis economies of scale, and we see
that too in very large organizations, and I think it's
you know, MGB has been public about saying that they're
struggling with integrating some of their departments across their hospitals.
Rather infamously shortly after then, Partner's Healthcare was created with now.
Speaker 5 (05:42):
Mass General Brigham.
Speaker 4 (05:44):
The Brigham was, you know, arguably the most famous maternity
hospital in the country, certainly in Boston, and Mass General
went right ahead and opened up a maternity ward to
compete with their own fellow hospital. So there's turf wars,
and those become inefficiencies of scale. So you've got this
enormous organization with lots and lots of people, lots of
(06:06):
money flowing through it. And as Jessica pointed out in
the article, and you're quoting maybe too many layers of management.
Speaker 3 (06:13):
Okay, the other thing that is interesting again, this is
a private institution. It employees eighty two thousand people. Do
we even know at this point, you know, a couple
of weeks after this story sort of percolated up, do
we know at this point how many employees have been
shown the door.
Speaker 4 (06:32):
I haven't seen that out there. No, I don't know
the answer to that, but I mean I can do.
Speaker 2 (06:40):
I can do.
Speaker 3 (06:41):
I can take two percent and multiply it by eighty
two thousand and come up with some figure like one thousand,
six hundred and forty and those when I've seen numbers,
I've seen that that sort of number, that fifteen hundred
roundown number. But there's been very little access to the
chief executive, doctor Ian Klebanski. I have not seen a
(07:04):
single long form interview with her in either of the
Boston newspapers on any of the Boston radio or television stations.
Have I missed And again I don't follow this as
closely as you have. I missed some sort of a
long form interview where she would talk beyond the ten
or twelve paragraph statement that the hospital released back on
(07:26):
February tenth.
Speaker 4 (07:28):
I don't think so, Dan, If you've missed it, I
missed it too.
Speaker 3 (07:31):
Okay, that's troubling. And again this is not a loaded question,
but I'd be interested. Do you think that a story
of this magnitude that the CEO should have should make
herself or himself available to you know, to public questioning
in the media, or is that not what that job
(07:53):
should require in your.
Speaker 4 (07:55):
Opinion, Well, I'm not going to comment on that. You know,
doctor coleban Ski is by all accounts a very talented leader,
and she'll make her own decisions as to what she
thinks is best for her institution. I think you're pointing
out though, that perhaps the public would be really interested
in hearing more. But what is the right thing for
(08:17):
her to do is not my business say.
Speaker 2 (08:19):
I always think.
Speaker 3 (08:20):
I always err on the side of openness, you know,
sunlight being the disinfectant and the idea that it stops
a lot of the speculation.
Speaker 2 (08:30):
If they say, okay, look we did.
Speaker 3 (08:32):
Have to lay off twelve hundred and fifty employees, or
we have to lay off two thousand employees, it's good
to sort of provide some structure and not try to
make it just a one day story, because it's not
a one day story. My guest is doctor John Friedman.
He's a healthcare expert. His view is much wider than
Mass General Brigham. But obviously the implications of Mass General
(08:53):
Brigham will have fallout for all of us when we
get back. I'd like to ask questions of view about
just the medical industry in America. It's it's such a
huge industry. And also talk a little bit, as we
talked about earlier today about we going in the right direction.
There are other models around the world that you're probably
(09:17):
more familiar with than I am. We talked about them
today a little bit. And also I'd like to give
people an opportunity to talk with you the number six, one, seven, two, five, four,
ten thirty six one, seven, nine, three, one, ten thirty.
I'm no expert on this. I'm just a typical person
who realizes that it is very difficult for many of
(09:38):
my listeners to find a doctor these days. I mean,
it was never that difficult, but it has become more difficult.
And I think that you will be able to tell
us why there seems to be such a dearth of
doctors available, uh, and maybe what we should be thinking
about going forward. My guest doctor John Friedman, and he
(09:59):
is a health care expert. If you want to join
the conversation and you have a question, and by the way,
if you happen to be someone in the medical field
and would like to continue this conversation or participate in
this conversation, I would invite you specifically because Frankly, all
of us need medical care throughout our lives, not only
at different points in our lives, but we need ongoing
(10:21):
medical care to make sure that whatever malady is eventually
going to strike us, we find out about it as
early as possible. Preventive maintenance in businesses and within corporations
and with machines are very important. Preventive maintenance, preventive medical
care for human beings is equally are arguably more important.
(10:44):
My name's Dan Ray. This is a nightside We'll be
right back after this.
Speaker 1 (10:48):
Now back to Dan Ray line from the Window World
Light Side Studios on WBZ News Radio.
Speaker 2 (10:55):
My guest is doctor John Freeman. He's a healthcare expert.
Speaker 3 (10:58):
He has been in this field for many, many years,
not only as a physician, but he also has an
MBA degree as well, so he's particularly well suited for
this conversation tonight. He's been quoted in the lead Boston
Globe story about this back on February tenth. Doctor Freeman,
it seems to me and I hear different reactions from
(11:22):
friends of mine who are doctors, and they tell me
that being a doctor, particularly being a primary care physician,
is not as prestigious or not as remunerative as it
once was.
Speaker 2 (11:34):
What has happened to that position in our society?
Speaker 3 (11:36):
I mean, when you and I were growing up, and
I'm a little older than you are, the idea of
someone become a doctor, you held them in great esteem
and great awe.
Speaker 2 (11:48):
Maybe we still do. But have we down valued the really.
Speaker 3 (11:53):
Important role that a doctor plays in all of our
lives and in our family families lives.
Speaker 4 (12:01):
Yeah, I think in some ways we have. And it's
particularly come down hard on primary care positions. Those are
family practitioners, general internal meediatricians, as well as behavioral practitioners,
where reimbursement levels have stagnated, And although certainly people in
those positions earn well above media and income, they also
(12:23):
work incredibly long hours, very stressful dealing with very sick
people and life or death stuff, and it's not an
easy job. And the age of our physician workforce, particularly
our primary care workforce, is getting older and many more
are going towards retirement and towards early retirement. So it
(12:44):
is more attractive, both financially and lifestyle wise to go
into a variety of specialties, but not all of them,
and primary caticlarly big trouble. And I think that's true
here in the Commonwealth, but it's also true around the country.
Speaker 3 (13:00):
If the cadre of physicians is getting older, so is
in our population.
Speaker 2 (13:05):
It is getting older.
Speaker 3 (13:06):
The baby boomers are now well into their retirement years
and their medical needs are only going to get greater.
Speaker 2 (13:15):
As time goes on.
Speaker 3 (13:17):
It seems to me that we might be looking at
some pretty tough times in the world of medicine between
supply and demand in the next ten or fifteen years.
Am I wrong on that or am I just being
dystopian in my view?
Speaker 4 (13:34):
No, I think we really could use an increase in
the number of geriatricians. Those are specialists in treating older adults.
Those specialists, although they are specialists and they get additional training,
to be honest, they don't get paid anything more than
a primary care physician. And so it's really tough. And
by definition, they're dealing with people who typically have multiple
(13:56):
chronic conditions, complex drug regimens, often have got terminal or
serious chronic conditions. It's really hard work and yeah, we're
not going to have enough of them, particularly as the
population continues to age. The medical needs are going up,
so we've got a problem. And some of this is
(14:18):
being addressed by bringing in more mid level practitioners physicians, sistants,
and nurse practitioners. But that's only gotten us so far.
Speaker 3 (14:26):
Yeah, how have we gotten to this point? We're the
wealthiest nation in the world, and we spend I think
you mentioned today to man, I've heard the figure before
that we spend more per capita on medical expenditures than
probably any other country in the world. And our results
(14:46):
aren't aren't as good as they should be. They have
no from that view of thirty thousand feet, what do
you see that on the landscape that really troubles you?
Speaker 4 (14:57):
But there must be a lot, Yeah, there's there are
a lot of problems. And American health care it's got
some amazing, magical stuff and incredible people who work in healthcare,
but you know, it's really discoordinated, maddening, and it fails
told good care to all of us. We are by
(15:19):
far the most expensive healthcare system amongst the whole developed world.
You look among the thirty richest countries that we spend
roughly fifty percent more than the number two country per capita,
and our outcomes aren't among the worst. You know, if
you look back forty fifty years ago, American life expect
and immortality were among the best among those thirty countries.
(15:41):
Now we are among the very worst. So we've actually
declined even as it's gotten so expensive. About twenty years ago,
there was a huge push in American medicine to address
the quality problem. You may remember there were these institution
medicine reports about addressing quality, and that was an important
It's been addressed to a degree. What's killing the system
(16:03):
now is cost. It is absolutely cost prohibitive. Small employers,
municipal government, state governments are being badly squeezed. And so
many of your listeners, I imagine, are on high desctable
health plans, probably have difficulty being able to pay the bills.
And the rates that are paid to the dominant healthcare
(16:27):
systems have skyrocketed. They far outpaced inflation and wages, and
so healthcare has become increasingly unaffordable to more and more people.
And that's a confluence of those things. But if you will,
it's stupid. That's really causing so much trouble.
Speaker 3 (16:49):
And the last thing I want to do is introduce
any politics to this conversation. But the reality is that
we're beginning to experience some cuts in federal money. Some
that would that would come back to the states. So
that's that's an intention and intentional decision by the federal government.
(17:09):
No idea how how far it will go, no idea
how far it might reach. But there are a lot
of institutions, particularly medical institutions that do research that now,
as well as educational institutions that now have to factor
in that maybe some of the money that would be
flowing from Washington is going to stop.
Speaker 2 (17:31):
Uh. That has to be a concern.
Speaker 3 (17:33):
And I wonder if that prompted mass General Brigham to
actually anticipate that and and impose some of these cuts.
Do you think that's potential, potentially a factor in their
decision to cut back.
Speaker 4 (17:49):
Well, their announcement didn't say so, and it came out
before many of these cuts were announced. At its surface,
it doesn't seem so. But of course I don't know
what's going on, you know, in the in the board
room there. But it's a it's a concern.
Speaker 5 (18:04):
You know.
Speaker 4 (18:04):
Medicare and medic are two programs that provide care to
over over one hundred million Americans and are a lifeline.
And yes, they add up to a heck of a
lot of money. They are among the biggest sources of
federal spending. They are also more cost efficient than private insurance,
(18:27):
but there's no getting around the fact that they're very expensive.
And it's not clear what's going to happen with this administration.
They've really said that they want to reduce spending in
the programs, but it's not clear. Well, next, my guest.
Speaker 3 (18:45):
Is doctor John Friedman. He's a healthcare expert. We're going
to get phone calls right after the nine thirty news.
It's nine thirty. We'll go to the news. We do
have a couple of lines still available if you want
to get in dial now six one seven ten or
six one seven, nine three, ten thirty. We'll be right
back on Nightside with doctor John Friedman.
Speaker 1 (19:06):
You're on Night Side with Dan Ray on Boston's News Radio.
Speaker 3 (19:12):
All right, my guest, doctor John Friedman. We are talking
about sadly about problems with America's medical care system. Doctor
Friedman is an expert in healthcare, and we're going to
go to phone calls as simple as that. Whatever you
would like to ask, feel free. We'll start it off
(19:33):
with Steve and Cambridge. Steve welcome you first this hour
with my guest, doctor John Freedman.
Speaker 6 (19:40):
Go right ahead, doctor Freedman. If Dan allows, I'd like
to ask two questions.
Speaker 3 (19:45):
Absolutely, you go right ahead. You one of my best callers,
doctor Friedman.
Speaker 2 (19:49):
She's a smart dude. Let me tell you. Go ahead,
go ahead, Steve.
Speaker 6 (19:52):
The first question is I looked on what appeared to
be in a legitimate website that tracked medical federal or
national medical expenses, and it seemed that since nineteen fifty
up until the present, the rate of increase has held
absolutely steady. This is an inflation adjusted dollars, and that
(20:18):
we're spending five times per capita more than we did
in nineteen fifty. I realized we're talking macroeconomics now. My
questions to you is, during that period of time, for example,
Americans have reduced their rate of smoking tremendously, and we've
also had the Affordable Care Act, but that doesn't seem
(20:42):
to have It appears from this graft that it doesn't
flatten the curve at all. Do you have any thoughts
on that?
Speaker 4 (20:52):
Sure, that's a great question, Steve, and you're absolutely right.
There has been an almost steady increase for decades. The
small dip for just a few years actually in the
mid nineties, where healthcare costs actually stayed flat for about
three straight years before resuming their upward trend, and that
(21:13):
was sort of the beginning of the HMO era. However,
you're right, it's been growing steadily and importantly two to
three per faster every year than wages, and through the
magic of compounding two to three percent over many decades,
has resulted in this difference. Yet, people are smoking less
and there are certain fewer risks, but also have far
(21:37):
more prevalence of unfortunate tight of sea that leads to
serious illness and hypatic cancer. There are many new wonderful
drugs that also happen to be quite expensive to treat
conditions we couldn't treat before. The population is aging. There
are valid reasons why we're spending on healthcare, and in
a certain sense it's giving us better life, longer life,
(22:01):
then that's a good investment. It may not be a
bad thing that we're spending five times as much if
we're happier, healthier, living longer lives. The tragedy of the
American healthcare system is that we're spending that money not
accomplishing those better outcomes.
Speaker 6 (22:17):
But the Affordable Care Act and the reduction in smoking
has had any benefit financially.
Speaker 4 (22:25):
But absolutely, I think the reduction smoking has definitely improved health.
People are getting less emphathma, fewer heart attacks. The risk
of heart attack has gone down tremendously in this country
thanks to reduction in smoking and cheap and really well
tolerated blood pressure medicines for example, So that has In fact,
(22:48):
the ACA did save a little bit of money in
some places, particularly for mediccare. Frankly, so it saved a
lot of money for our program. But the biggest thing
about the A that had expanded eligibility. We used to
have about fifteen percent of Americans with no access to
health insurance. I got cut roughly in half, and so
(23:12):
that we were able to do that without radically thing spending,
which was a true but net did it save money?
Speaker 5 (23:22):
Not much.
Speaker 6 (23:24):
One more question. Around the year two thousand, Francis Cons
was the head of the Genome Project and they completed
mapping the human genome and Bill Clinton said it would
revolutionize medicine. Francis Cons also said in ten to fifteen years,
all kinds of cures would be coming out using adult
(23:48):
stem cells. I think, well, now it's twenty five years later,
has this proven to be the case where it was?
This perhaps a bit of hype in there.
Speaker 4 (24:02):
Actually, yes, there's a bit of height. It might have
been a little bit of optimism, but some of it
absolutely has with a big price tag. So there are
some therapies known as cart which are basically might cells
for treating certain illnesses. Uh and therapy first successful time
to treat sickle cell anemia, a terrible crippling disease that
(24:27):
now replaced the faulty gene. It's treatments though one million
to three million dollars do Again, maybe they're well worth
it because of what we consider to be the value
of a longer and healthier life. But they're not cheap.
But when I was in my medical training in the
(24:51):
eighties and nineties, when we gave chemotherapy to a patient
with cancer, these were really tough drugs that really blasted
the body and kill the cancer cells, but killed a
lot of healthy cells and frankly made patients very sick.
Modern cancer care realize much less so called sid of
toxic drugs or on these targeted therapies that get not
(25:15):
only more effects treating but has far side effects.
Speaker 6 (25:19):
So have stem cells stem cell therapy lived up to
its promises?
Speaker 4 (25:27):
Probably not, Probably not to the hype that within fifteen
years would fix everything.
Speaker 6 (25:31):
No, oh great, thank you very much, doctor Freeman. Very interesting.
Speaker 2 (25:36):
Thank you.
Speaker 3 (25:37):
Questions never never disappoint my friend. Thank you, have a
great one. Let's go next to Mary in Swampskott.
Speaker 5 (25:44):
Mary.
Speaker 2 (25:44):
Welcome.
Speaker 3 (25:45):
You're on with doctor John Friedman, a healthcare expert. Your
questions or comments?
Speaker 2 (25:49):
Mary?
Speaker 7 (25:51):
All right, Hi, thank you, thank you for taking my questions.
I don't have to click to the doctor. But an
employee of MGB and on February tenth, the Boston Globe
had the article about the layoffs and we were not notified.
Speaker 3 (26:18):
So you learned about the layoffs from the Boston Globe
as opposed to from your employers.
Speaker 2 (26:22):
What you're what you're saying, Yeah.
Speaker 7 (26:24):
They didn't tell us until like maybe nine point thirty
that day, and several employees were laid off that morning.
It's kind of blindsided. So the past.
Speaker 2 (26:42):
What's your question?
Speaker 3 (26:42):
I think I know where you're going, but what would
you and don't be nervous when we just want to
give you a chance to ask whatever you want, go
right ahead.
Speaker 7 (26:50):
Yeah. So you know, in the past, if an employee left,
we weren't allowed to backfill it. People are working a
lot long hours and we're just like concerned about the
next layoff. We just implemented a new system and people
(27:11):
are working crazy hours and they're in fear of being
laid off.
Speaker 2 (27:18):
Can I ask you question, Mary? Can I ask you
a question? Okay?
Speaker 3 (27:22):
Have they has the management at MGB ever told the
employees what the scope of the layoffs either has been
or will be?
Speaker 7 (27:32):
No? Absolutely not. People are saying, you know, I don't have.
Speaker 3 (27:36):
No idea, You have no idea if the layoffs are
over at this point, right.
Speaker 7 (27:42):
No, So there is supposed to be another layoff in March,
and if you ask a manager, they say, we don't know.
I can't make the decision.
Speaker 2 (27:53):
So, okay, we hear this, this sort of anxiety. I
hear it in you. Do you have a question for
doctor Friedman?
Speaker 7 (28:03):
Well, yeah, no, not I do not, but I wanted
to like express my feelings about the layoffs.
Speaker 3 (28:12):
Well, I want you to know that at least I'm
sure Doctor Friedman joins me in saying that that we
we realize how much, how hard all of you have
worked and I think it's a tragedy that you have
been treated this way if you have not been given,
you know, at least some assurance or given advance notice
(28:35):
that you were going to be laid off, that's no
way to treat employees, to keep people anxiety.
Speaker 7 (28:42):
My comments, but it was one we can hear.
Speaker 2 (28:48):
We can hear the sincerity in your voice.
Speaker 3 (28:49):
Perhaps doctor Freeman would like to comment, Doctor, do you
have a comment for Mary?
Speaker 4 (28:53):
No, I'll like what you said, Dan, Yeah, you and
your colleagues.
Speaker 7 (28:59):
Yeah.
Speaker 4 (29:00):
I mean, I don't have more to say, but that
that does terribly still and unfortunate, and I'm sorry you're
in that predicular.
Speaker 5 (29:08):
Mary.
Speaker 3 (29:08):
I'm so glad that when you listen to my show,
please keep listening and keep us posted as to how
this works out. I'm hoping that you were spared this.
How many years have you worked there? If you want
to tell me roughly, don't tell me precisely.
Speaker 8 (29:23):
Twenty two twenty two years.
Speaker 7 (29:25):
And the people that got laid off for excellent employees,
it was very random, like no rhyme or reason.
Speaker 3 (29:32):
So yeah, and were they were a lot of them
frontline people or were they administrators.
Speaker 7 (29:40):
It's all administrators, but like some vps, some controllers, some managers,
so very random. I guess yeah.
Speaker 3 (29:51):
Okay, well, please hang in there, Mary, and again again
thank you.
Speaker 2 (29:54):
For what you do.
Speaker 3 (29:54):
And I'm so sorry that you're in this feeling of
suspended anxiety.
Speaker 2 (30:00):
I can hear it in your voice. Thank you so much.
Speaker 7 (30:02):
Okay, all right, thank you so much.
Speaker 2 (30:04):
You're welcome.
Speaker 3 (30:05):
You're welcome to take a quick break back with my guest,
doctor John Friedman.
Speaker 2 (30:08):
That was what I was talking about before.
Speaker 3 (30:10):
Doctor Freedman, about the inaccessibility of information not only for
the public, but also for the employees. This is not,
in my opinion, good management style. But that's my that's
my opinion, and I'm not asking to join me on it.
We'll take a break and I will ask you to
stick with us for one other segment and we'll get
more questions. I got Jack and John and Brian and John.
(30:32):
We'll get them all in hopefully between now and ten o'clock.
Coming right back on night Side.
Speaker 1 (30:36):
Now, back to Dan Ray live from the Window World
night Side Studios on WBZ News Radio.
Speaker 2 (30:43):
Back to the phones, we go. Let me go to
Jack in Newton.
Speaker 3 (30:46):
Jack, you're on with doctor John Friedman. He is a
healthcare expert physician as well as an MBA.
Speaker 2 (30:51):
Go right ahead, Jack, how.
Speaker 9 (30:53):
Do you do doctor Freedman? I agree with things you
said there's a shortage, but I would say there's another reason.
My late wife wasn't an obg y n obstetrician pynecologist
from Ukraine, and she had delivered hundreds of babies, but
she was told to go back to school and she
(31:15):
didn't want to. So I blame the American medical societies
for being so strict and having, you know, so little
respect for the medical schools of other countries with the shortage. Excellent, Well, that.
Speaker 3 (31:31):
Gets to a question Jack, we've talked out before about
before as we have so many young, bright people who
are going off short of medical schools a doctor, can
you address That's a point that I think is really good.
When the Jack rays I'm so sorry about the loss
of his wife, could you address that so many young
people go off short when I mean schools outside the
US to earn the medical degrees, and then it's difficult
(31:52):
for them to get back here and get residency. It's
it's it's kind of a crazy situation right now.
Speaker 2 (31:58):
In my opinion doctor.
Speaker 4 (32:00):
Even Yeah, yeah, no, I think you're right. There's a
portion of the American medical colleges and that on the
training programs here in you know, in association with state licensures.
You're right, Jack, really unfortunate, so we only recognize medical
degrees certain countries, Canada, the US, a limited number of
(32:24):
Caribbean medical schools, perhaps a few others that I'm not
sure of, but certainly not your wife. And there are
valid reasons for that, but it's also problematic if people
need to do it. And I've heard many stories of
people who are trained abroad and have to take other,
you know, parafl jobs because they're not qualified lest they
(32:47):
redo their medical education. So perhaps there are things that
can be done along those lines to help increase our
supply of physicians. And of course there needs to be
a trade to make sure that they're well trained. They are,
but why not you're out of way to make that happen,
and go forward, Jack.
Speaker 3 (33:05):
Jack, I appreciate that I got I got three callers
behind you, and you made such a great point. I'm
going to ask if I can move on and get
these other three callers in as well. But thank you
for the points you've made to because it's a very
important point. Thank you, welcome, Thanks Jack, I appreciate. I'll
make it up to you next time. Brian and Pellham,
(33:25):
New Hampshire. Brian, you're next with doctor John Friedman. Go
right ahead, Brian.
Speaker 10 (33:29):
Yeah, I'm a first time caller.
Speaker 2 (33:31):
All right, welcome. We'll give you a lot of applause here.
I'm seeing your audience. Go right ahead, chat, go right ahead, Brian.
Speaker 10 (33:38):
Yeah. So what I have a problem is with every
time you get sick or anything, you have to go
to the emergency room, even even if you go to
a walk in clinic. And I have Crohn's disease, right,
and I get stomach infections a lot. I have blockages
(34:01):
every once in a while, and I'll even you know,
I have to I go to the walk ins and
they say you got to go to the instead of
putting you in the hospital, you have to go to
the emergency room. And sometimes I set in the emergency
room five hours.
Speaker 4 (34:20):
I mean years ago.
Speaker 10 (34:22):
I had a general practitioner which she's retired since.
Speaker 4 (34:26):
And he was great.
Speaker 10 (34:27):
I had him for thirty years or.
Speaker 5 (34:29):
So, and.
Speaker 10 (34:31):
He, you know, if I had something like that, he
would send me right over to the hospital, and now
they say that they can't. What I have now is
a nurse practitioner and she tells me that she can't
do that. Everybody has to go through the emergency room first.
Is that am I correctness?
Speaker 4 (34:51):
I think that's the way it's become. Brian and well,
I'm really sorry to hear that Chrome's disease can be
a terrible condition, and it can be very complex, and
sitting in an emergency room.
Speaker 5 (35:04):
I hate to say it.
Speaker 4 (35:05):
If you've been there for five hours, maybe you were lucky.
There are too many stories of people who spend more
time than that. Yeah, many hops are so overcrowded that
they force a urgency room. And I think efficiency and
the lystics of how we're practicing medicine have, sadly, in
(35:26):
some ways, just gotten worse. This is what I try
to professionally. We work with a lot of state health agencies.
I'm trying to make health care better, but it's been
really hard. So I think your observation is on track,
and sadly.
Speaker 2 (35:43):
I wish we had a better answer for you.
Speaker 3 (35:45):
But you've raised the issue and I think it's an
important one, and I agree with you totally thank you
for calling you.
Speaker 2 (35:51):
I look forward to your next call. Thanks, Brian, appreciate it,
Thank you, take care, good night.
Speaker 3 (35:55):
Let's go to We have two Johns in Boston, so
John and Boston go right ahead.
Speaker 8 (36:01):
Basi and doctor Freeman's quick thank you, just quick question.
I was talking to a medical professional. This week's kind
of upsetting. A childhead a tumor went to Mass General
supposed to get read some kind of treatment for his
brain tumor. He had a schedule appointment, an appointment was postponed,
rescheduled for a child who's and this child is a
US citizen, for a non US citizen child to come
(36:24):
in and get treatment in his in his place. And
I'm just wondered, is that a common practice. It was
just upsetting that a US child would schedule the pointment
would be moved out for a child from who's a
non citizen. I'm just wondered that was a common joh
And I don't.
Speaker 3 (36:41):
Know how doctor Freeman could even address that because he
has h you know, no, doesn't understand the situation. Doctor Freeman,
I I can take you off the hook here, but
because I don't know that you're able to address a
specific set of circumstances like this. I don't think it's
probably something that happens frequently. You want to comment at.
Speaker 4 (36:59):
All, and well, uh, just to say that I, yes,
I think this was quite an unusual thing. Be more
than just verify exactly what happened, because that does not
at all sound like the sort of thing that normally happened.
Of course, I have no idea what happened.
Speaker 3 (37:18):
Any child who's in for treatment for a brain tumor
should should ever be uh should have his his his.
Speaker 2 (37:25):
Treatment postponed for any reason whatsoever.
Speaker 5 (37:27):
John, Okay, No, I appreciate it.
Speaker 8 (37:30):
Uh, this person was upsets, very upset.
Speaker 2 (37:34):
So again we're talking about a.
Speaker 3 (37:37):
Senate circumstances we know nothing about. And so therefore I'm
just gonna let you go for now and gry to
get one more call in him before the hour.
Speaker 2 (37:44):
sOliver.
Speaker 3 (37:44):
Thanks, John, appreciate it. Let me go to the other
John in Boston. John, and Boston, you were next one. Nice,
I go right ahead.
Speaker 5 (37:51):
Thank you, damn doctor, thank you doctor. God most result. Yeah,
it's a it's a shame because uh, with gentlemen just said,
the layoffs not being given their heads up, and you know,
we were known as probably one of the best places
in the world were coming. I'm not being biased because
of Boston. You know, I was born and race here,
(38:13):
but that other than California and Florida. But that's being said.
You know, you don't want to bring politics in it,
and I can't understand that. I know hospitals that were
given sinus ten thousands of new employees, nurses, and I
just listened. I didn't say a word right in Boston,
and then some of them were leaving after a month,
six months, a year, and I said, wasn't in a
(38:35):
situation put in this, No, not at all. But yet
the people that have been there twenty thirty what years?
What were they given?
Speaker 2 (38:43):
Yeah?
Speaker 3 (38:43):
And again, John, we have no way of knowing. I'm
sure what you're telling us is the absolute truth. But
I don't know that Doctor Friedman could comment on on that.
Speaker 2 (38:51):
Have you ever heard that before? Doctor Freeman?
Speaker 4 (38:53):
Well, yeah, I can't from that physic thing. But let
me make it. I'm on a broader point that I make, John,
which is about pride in the hospitals and the quality
of Boston. Remain very proud of the excellent care. We
have a number of really outstanding centers in addition to
mess you know at Real Laty Clinic, Toughs Medical Center,
(39:16):
Boston Medical Center Center, We've got a whole bunch of
elite places to get care. So that means we'll still
remain focus of it. I think a danger have is
that not just in Massachusetts, but around the there's been
a lot of merger consolidation. Certainly we've seen with the
(39:38):
the of mass Journal, Brigham particular, also the Lady Network,
and again I'm not going to comment on them specifically,
but when you look at the data hospital mergers around
the country, when they merge, the costs go up, and
while in the service do go up, and fortunately, damn, it's.
Speaker 3 (40:01):
Just unfortunately, gentlemen, I've got to bring it to a
close here because we're actually now brushing up against the
ten o'clock newscast. Doctor John, thank you for the call
and comment. And doctor Freeman, thank you very much for
your tonight. Really do appreciate it, and I'd love to
have you back at some point.
Speaker 4 (40:18):
Okay, it would be my pleasure. Dam Thanks so much,
Thanks so.
Speaker 2 (40:22):
Much, really thank all the conversation.
Speaker 3 (40:24):
All right, thanks, when we get back, we're going to
change topics. Those of you who are calling in now
are a little late. We'll change topics and we're going
to talk about little politics in the ten o'clock hour
back after the ten
It's night Side with Dan Ray on WBZ Costin's Radio.
Speaker 2 (00:06):
Thank you very much.
Speaker 3 (00:07):
Al As we move into our nine o'clock hour tonight,
it is about nine oh seven. My name is Dan Ray,
host of Nightside, and we're going to talk about the
Mass General Brigham layoff, largest layoff in its history, amid
ongoing restructure.
Speaker 2 (00:25):
This story broke in early.
Speaker 3 (00:28):
February, mid February runs the ninth or tenth of February,
a couple of weeks ago, well yeah, about ten, ten
eleven days ago, and the subheadline of the Globe article,
written by Jessica Bartlett, was facing rising costs and hoping
to make it sprawling network more efficient. The state's largest
private employer aims to cut payroll costs by over two
(00:51):
hundred million dollars MGB. Mass General Brigham employees approximately eighty
two thousand people, and they intend to save at least
two hundred million dollars annually.
Speaker 2 (01:07):
So these are big numbers.
Speaker 3 (01:08):
Okay, two percent of its salary and benefits cost. That's
sort of the big picture for you and me to
understand that we have brought into the conversation tonight doctor
John Friedman, who not only is a physician doctor an MD,
but he also has an MBA. He is a graduate
(01:28):
of Harvard, University of Pennsylvania School of Medicine, and the
University of Louisville School of Business. Doctor John Friedman is
a healthcare leader CEO of Freedman Healthcare, LLC. Doctor Freedman,
Welcome to Nights Ott.
Speaker 4 (01:44):
How are you doing well, Ben, Thanks for having.
Speaker 3 (01:47):
Me well, Thank you very much for joining us. This
was a blockbuster story in my mind. Am I overstating
that when an institution as important Mass General Brigham is
to our community announces layoffs and cuts as draconian or
(02:11):
dramatic as this.
Speaker 4 (02:14):
I'm going to say. I'm going to say yes and no.
It's note worthy because this is certainly an unusual event.
But in the scheme of things, it's no secret that,
you know, mass General Brigham is the most expensive hospital
network in Massachusetts. They are also the dominant network in Massachusetts,
and they've been under a lot of pressure to get
their prices down, frankly, and it hasn't happened. So, you know,
(02:35):
the state and private employers have been trying to get
them to reduce their prices, and this might be actually
a beneficial sign that they're tightening the belt. Apparently these
cuts are to non clinical positions, to administrators, and maybe
this is all a good thing. At the same time, Dan,
(02:55):
I think you may be onto something that you know,
it's concerning that this is by are the richest. I've
got very deep pockets. They're a very wealthy organization. You know,
they're needing to cut What does that mean for the
rest of the Massachusetts health ecosystem, especially in the wake
of the debacle that is Stuart Healthcare and what we're
dealing with the fall out there.
Speaker 3 (03:16):
Yeah, we have Stuart Healthcare. We have a number of
sort of undercurrents in this pool. If we think of
the medical health care system sort of.
Speaker 2 (03:25):
As a pool of water.
Speaker 3 (03:27):
We may not quite see it on the surface yet,
but clearly you have the Stewart dilemma tragedy and the
loss of at least a couple of hospitals, who knows,
maybe eventually more. You also have a dearth of PCP
personal care physicians. It's tougher for people to get a
doctor these days anymore, and I think that probably a
(03:52):
lot of people who normally might have a physician who
they would go to now can't get a physician and
they end up at emergency rooms or just going to hospitals.
So I think there's some trends underwater that I want
to look at. I want to read one paragraph to
you and have you interpreted for me from the Boston
(04:13):
Global article by Jessica Bartlett of February tenth, which is
a really good article by the way.
Speaker 2 (04:20):
She wrote.
Speaker 3 (04:21):
Studies of Mass General Brigham's management structure also revealed that
Mass General Brigham had more managers per frontline worker than
industry benchmarks, duplicative management roles, and many layers of managers.
Executive said, while high performing organizations may have maybe seven
(04:43):
or eight layers of management between the frontline worker and
the CEO, in some places at Mass General Brigham there
were fifteen layers of management. How does any business function
with fifteen layers of management or mid management.
Speaker 4 (05:00):
I think the short order is it's really hard to
And I think a reality is that when healthcare organizations merge,
they will always put out public statements about how they're
going to get efficiencies of scale. Economies of scale, they're
going to save money on accounting, on purchasing equipment, they're
going to be able to do all kinds of things.
(05:21):
There are also dis economies of scale, and we see
that too in very large organizations, and I think it's
you know, MGB has been public about saying that they're
struggling with integrating some of their departments across their hospitals.
Rather infamously shortly after then, Partner's Healthcare was created with now.
Speaker 5 (05:42):
Mass General Brigham.
Speaker 4 (05:44):
The Brigham was, you know, arguably the most famous maternity
hospital in the country, certainly in Boston, and Mass General
went right ahead and opened up a maternity ward to
compete with their own fellow hospital. So there's turf wars,
and those become inefficiencies of scale. So you've got this
enormous organization with lots and lots of people, lots of
(06:06):
money flowing through it. And as Jessica pointed out in
the article, and you're quoting maybe too many layers of management.
Speaker 3 (06:13):
Okay, the other thing that is interesting again, this is
a private institution. It employees eighty two thousand people. Do
we even know at this point, you know, a couple
of weeks after this story sort of percolated up, do
we know at this point how many employees have been
shown the door.
Speaker 4 (06:32):
I haven't seen that out there. No, I don't know
the answer to that, but I mean I can do.
Speaker 2 (06:40):
I can do.
Speaker 3 (06:41):
I can take two percent and multiply it by eighty
two thousand and come up with some figure like one thousand,
six hundred and forty and those when I've seen numbers,
I've seen that that sort of number, that fifteen hundred
roundown number. But there's been very little access to the
chief executive, doctor Ian Klebanski. I have not seen a
(07:04):
single long form interview with her in either of the
Boston newspapers on any of the Boston radio or television stations.
Have I missed And again I don't follow this as
closely as you have. I missed some sort of a
long form interview where she would talk beyond the ten
or twelve paragraph statement that the hospital released back on
(07:26):
February tenth.
Speaker 4 (07:28):
I don't think so, Dan, If you've missed it, I
missed it too.
Speaker 3 (07:31):
Okay, that's troubling. And again this is not a loaded question,
but I'd be interested. Do you think that a story
of this magnitude that the CEO should have should make
herself or himself available to you know, to public questioning
in the media, or is that not what that job
(07:53):
should require in your.
Speaker 4 (07:55):
Opinion, Well, I'm not going to comment on that. You know,
doctor coleban Ski is by all accounts a very talented leader,
and she'll make her own decisions as to what she
thinks is best for her institution. I think you're pointing
out though, that perhaps the public would be really interested
in hearing more. But what is the right thing for
(08:17):
her to do is not my business say.
Speaker 2 (08:19):
I always think.
Speaker 3 (08:20):
I always err on the side of openness, you know,
sunlight being the disinfectant and the idea that it stops
a lot of the speculation.
Speaker 2 (08:30):
If they say, okay, look we did.
Speaker 3 (08:32):
Have to lay off twelve hundred and fifty employees, or
we have to lay off two thousand employees, it's good
to sort of provide some structure and not try to
make it just a one day story, because it's not
a one day story. My guest is doctor John Friedman.
He's a healthcare expert. His view is much wider than
Mass General Brigham. But obviously the implications of Mass General
(08:53):
Brigham will have fallout for all of us when we
get back. I'd like to ask questions of view about
just the medical industry in America. It's it's such a
huge industry. And also talk a little bit, as we
talked about earlier today about we going in the right direction.
There are other models around the world that you're probably
(09:17):
more familiar with than I am. We talked about them
today a little bit. And also I'd like to give
people an opportunity to talk with you the number six, one, seven, two, five, four,
ten thirty six one, seven, nine, three, one, ten thirty.
I'm no expert on this. I'm just a typical person
who realizes that it is very difficult for many of
(09:38):
my listeners to find a doctor these days. I mean,
it was never that difficult, but it has become more difficult.
And I think that you will be able to tell
us why there seems to be such a dearth of
doctors available, uh, and maybe what we should be thinking
about going forward. My guest doctor John Friedman, and he
(09:59):
is a health care expert. If you want to join
the conversation and you have a question, and by the way,
if you happen to be someone in the medical field
and would like to continue this conversation or participate in
this conversation, I would invite you specifically because Frankly, all
of us need medical care throughout our lives, not only
at different points in our lives, but we need ongoing
(10:21):
medical care to make sure that whatever malady is eventually
going to strike us, we find out about it as
early as possible. Preventive maintenance in businesses and within corporations
and with machines are very important. Preventive maintenance, preventive medical
care for human beings is equally are arguably more important.
(10:44):
My name's Dan Ray. This is a nightside We'll be
right back after this.
Speaker 1 (10:48):
Now back to Dan Ray line from the Window World
Light Side Studios on WBZ News Radio.
Speaker 2 (10:55):
My guest is doctor John Freeman. He's a healthcare expert.
Speaker 3 (10:58):
He has been in this field for many, many years,
not only as a physician, but he also has an
MBA degree as well, so he's particularly well suited for
this conversation tonight. He's been quoted in the lead Boston
Globe story about this back on February tenth. Doctor Freeman,
it seems to me and I hear different reactions from
(11:22):
friends of mine who are doctors, and they tell me
that being a doctor, particularly being a primary care physician,
is not as prestigious or not as remunerative as it
once was.
Speaker 2 (11:34):
What has happened to that position in our society?
Speaker 3 (11:36):
I mean, when you and I were growing up, and
I'm a little older than you are, the idea of
someone become a doctor, you held them in great esteem
and great awe.
Speaker 2 (11:48):
Maybe we still do. But have we down valued the really.
Speaker 3 (11:53):
Important role that a doctor plays in all of our
lives and in our family families lives.
Speaker 4 (12:01):
Yeah, I think in some ways we have. And it's
particularly come down hard on primary care positions. Those are
family practitioners, general internal meediatricians, as well as behavioral practitioners,
where reimbursement levels have stagnated, And although certainly people in
those positions earn well above media and income, they also
(12:23):
work incredibly long hours, very stressful dealing with very sick
people and life or death stuff, and it's not an
easy job. And the age of our physician workforce, particularly
our primary care workforce, is getting older and many more
are going towards retirement and towards early retirement. So it
(12:44):
is more attractive, both financially and lifestyle wise to go
into a variety of specialties, but not all of them,
and primary caticlarly big trouble. And I think that's true
here in the Commonwealth, but it's also true around the country.
Speaker 3 (13:00):
If the cadre of physicians is getting older, so is
in our population.
Speaker 2 (13:05):
It is getting older.
Speaker 3 (13:06):
The baby boomers are now well into their retirement years
and their medical needs are only going to get greater.
Speaker 2 (13:15):
As time goes on.
Speaker 3 (13:17):
It seems to me that we might be looking at
some pretty tough times in the world of medicine between
supply and demand in the next ten or fifteen years.
Am I wrong on that or am I just being
dystopian in my view?
Speaker 4 (13:34):
No, I think we really could use an increase in
the number of geriatricians. Those are specialists in treating older adults.
Those specialists, although they are specialists and they get additional training,
to be honest, they don't get paid anything more than
a primary care physician. And so it's really tough. And
by definition, they're dealing with people who typically have multiple
(13:56):
chronic conditions, complex drug regimens, often have got terminal or
serious chronic conditions. It's really hard work and yeah, we're
not going to have enough of them, particularly as the
population continues to age. The medical needs are going up,
so we've got a problem. And some of this is
(14:18):
being addressed by bringing in more mid level practitioners physicians, sistants,
and nurse practitioners. But that's only gotten us so far.
Speaker 3 (14:26):
Yeah, how have we gotten to this point? We're the
wealthiest nation in the world, and we spend I think
you mentioned today to man, I've heard the figure before
that we spend more per capita on medical expenditures than
probably any other country in the world. And our results
(14:46):
aren't aren't as good as they should be. They have
no from that view of thirty thousand feet, what do
you see that on the landscape that really troubles you?
Speaker 4 (14:57):
But there must be a lot, Yeah, there's there are
a lot of problems. And American health care it's got
some amazing, magical stuff and incredible people who work in healthcare,
but you know, it's really discoordinated, maddening, and it fails
told good care to all of us. We are by
(15:19):
far the most expensive healthcare system amongst the whole developed world.
You look among the thirty richest countries that we spend
roughly fifty percent more than the number two country per capita,
and our outcomes aren't among the worst. You know, if
you look back forty fifty years ago, American life expect
and immortality were among the best among those thirty countries.
(15:41):
Now we are among the very worst. So we've actually
declined even as it's gotten so expensive. About twenty years ago,
there was a huge push in American medicine to address
the quality problem. You may remember there were these institution
medicine reports about addressing quality, and that was an important
It's been addressed to a degree. What's killing the system
(16:03):
now is cost. It is absolutely cost prohibitive. Small employers,
municipal government, state governments are being badly squeezed. And so
many of your listeners, I imagine, are on high desctable
health plans, probably have difficulty being able to pay the bills.
And the rates that are paid to the dominant healthcare
(16:27):
systems have skyrocketed. They far outpaced inflation and wages, and
so healthcare has become increasingly unaffordable to more and more people.
And that's a confluence of those things. But if you will,
it's stupid. That's really causing so much trouble.
Speaker 3 (16:49):
And the last thing I want to do is introduce
any politics to this conversation. But the reality is that
we're beginning to experience some cuts in federal money. Some
that would that would come back to the states. So
that's that's an intention and intentional decision by the federal government.
(17:09):
No idea how how far it will go, no idea
how far it might reach. But there are a lot
of institutions, particularly medical institutions that do research that now,
as well as educational institutions that now have to factor
in that maybe some of the money that would be
flowing from Washington is going to stop.
Speaker 2 (17:31):
Uh. That has to be a concern.
Speaker 3 (17:33):
And I wonder if that prompted mass General Brigham to
actually anticipate that and and impose some of these cuts.
Do you think that's potential, potentially a factor in their
decision to cut back.
Speaker 4 (17:49):
Well, their announcement didn't say so, and it came out
before many of these cuts were announced. At its surface,
it doesn't seem so. But of course I don't know
what's going on, you know, in the in the board
room there. But it's a it's a concern.
Speaker 5 (18:04):
You know.
Speaker 4 (18:04):
Medicare and medic are two programs that provide care to
over over one hundred million Americans and are a lifeline.
And yes, they add up to a heck of a
lot of money. They are among the biggest sources of
federal spending. They are also more cost efficient than private insurance,
(18:27):
but there's no getting around the fact that they're very expensive.
And it's not clear what's going to happen with this administration.
They've really said that they want to reduce spending in
the programs, but it's not clear. Well, next, my guest.
Speaker 3 (18:45):
Is doctor John Friedman. He's a healthcare expert. We're going
to get phone calls right after the nine thirty news.
It's nine thirty. We'll go to the news. We do
have a couple of lines still available if you want
to get in dial now six one seven ten or
six one seven, nine three, ten thirty. We'll be right
back on Nightside with doctor John Friedman.
Speaker 1 (19:06):
You're on Night Side with Dan Ray on Boston's News Radio.
Speaker 3 (19:12):
All right, my guest, doctor John Friedman. We are talking
about sadly about problems with America's medical care system. Doctor
Friedman is an expert in healthcare, and we're going to
go to phone calls as simple as that. Whatever you
would like to ask, feel free. We'll start it off
(19:33):
with Steve and Cambridge. Steve welcome you first this hour
with my guest, doctor John Freedman.
Speaker 6 (19:40):
Go right ahead, doctor Freedman. If Dan allows, I'd like
to ask two questions.
Speaker 3 (19:45):
Absolutely, you go right ahead. You one of my best callers,
doctor Friedman.
Speaker 2 (19:49):
She's a smart dude. Let me tell you. Go ahead,
go ahead, Steve.
Speaker 6 (19:52):
The first question is I looked on what appeared to
be in a legitimate website that tracked medical federal or
national medical expenses, and it seemed that since nineteen fifty
up until the present, the rate of increase has held
absolutely steady. This is an inflation adjusted dollars, and that
(20:18):
we're spending five times per capita more than we did
in nineteen fifty. I realized we're talking macroeconomics now. My
questions to you is, during that period of time, for example,
Americans have reduced their rate of smoking tremendously, and we've
also had the Affordable Care Act, but that doesn't seem
(20:42):
to have It appears from this graft that it doesn't
flatten the curve at all. Do you have any thoughts
on that?
Speaker 4 (20:52):
Sure, that's a great question, Steve, and you're absolutely right.
There has been an almost steady increase for decades. The
small dip for just a few years actually in the
mid nineties, where healthcare costs actually stayed flat for about
three straight years before resuming their upward trend, and that
(21:13):
was sort of the beginning of the HMO era. However,
you're right, it's been growing steadily and importantly two to
three per faster every year than wages, and through the
magic of compounding two to three percent over many decades,
has resulted in this difference. Yet, people are smoking less
and there are certain fewer risks, but also have far
(21:37):
more prevalence of unfortunate tight of sea that leads to
serious illness and hypatic cancer. There are many new wonderful
drugs that also happen to be quite expensive to treat
conditions we couldn't treat before. The population is aging. There
are valid reasons why we're spending on healthcare, and in
a certain sense it's giving us better life, longer life,
(22:01):
then that's a good investment. It may not be a
bad thing that we're spending five times as much if
we're happier, healthier, living longer lives. The tragedy of the
American healthcare system is that we're spending that money not
accomplishing those better outcomes.
Speaker 6 (22:17):
But the Affordable Care Act and the reduction in smoking
has had any benefit financially.
Speaker 4 (22:25):
But absolutely, I think the reduction smoking has definitely improved health.
People are getting less emphathma, fewer heart attacks. The risk
of heart attack has gone down tremendously in this country
thanks to reduction in smoking and cheap and really well
tolerated blood pressure medicines for example, So that has In fact,
(22:48):
the ACA did save a little bit of money in
some places, particularly for mediccare. Frankly, so it saved a
lot of money for our program. But the biggest thing
about the A that had expanded eligibility. We used to
have about fifteen percent of Americans with no access to
health insurance. I got cut roughly in half, and so
(23:12):
that we were able to do that without radically thing spending,
which was a true but net did it save money?
Speaker 5 (23:22):
Not much.
Speaker 6 (23:24):
One more question. Around the year two thousand, Francis Cons
was the head of the Genome Project and they completed
mapping the human genome and Bill Clinton said it would
revolutionize medicine. Francis Cons also said in ten to fifteen years,
all kinds of cures would be coming out using adult
(23:48):
stem cells. I think, well, now it's twenty five years later,
has this proven to be the case where it was?
This perhaps a bit of hype in there.
Speaker 4 (24:02):
Actually, yes, there's a bit of height. It might have
been a little bit of optimism, but some of it
absolutely has with a big price tag. So there are
some therapies known as cart which are basically might cells
for treating certain illnesses. Uh and therapy first successful time
to treat sickle cell anemia, a terrible crippling disease that
(24:27):
now replaced the faulty gene. It's treatments though one million
to three million dollars do Again, maybe they're well worth
it because of what we consider to be the value
of a longer and healthier life. But they're not cheap.
But when I was in my medical training in the
(24:51):
eighties and nineties, when we gave chemotherapy to a patient
with cancer, these were really tough drugs that really blasted
the body and kill the cancer cells, but killed a
lot of healthy cells and frankly made patients very sick.
Modern cancer care realize much less so called sid of
toxic drugs or on these targeted therapies that get not
(25:15):
only more effects treating but has far side effects.
Speaker 6 (25:19):
So have stem cells stem cell therapy lived up to
its promises?
Speaker 4 (25:27):
Probably not, Probably not to the hype that within fifteen
years would fix everything.
Speaker 6 (25:31):
No, oh great, thank you very much, doctor Freeman. Very interesting.
Speaker 2 (25:36):
Thank you.
Speaker 3 (25:37):
Questions never never disappoint my friend. Thank you, have a
great one. Let's go next to Mary in Swampskott.
Speaker 5 (25:44):
Mary.
Speaker 2 (25:44):
Welcome.
Speaker 3 (25:45):
You're on with doctor John Friedman, a healthcare expert. Your
questions or comments?
Speaker 2 (25:49):
Mary?
Speaker 7 (25:51):
All right, Hi, thank you, thank you for taking my questions.
I don't have to click to the doctor. But an
employee of MGB and on February tenth, the Boston Globe
had the article about the layoffs and we were not notified.
Speaker 3 (26:18):
So you learned about the layoffs from the Boston Globe
as opposed to from your employers.
Speaker 2 (26:22):
What you're what you're saying, Yeah.
Speaker 7 (26:24):
They didn't tell us until like maybe nine point thirty
that day, and several employees were laid off that morning.
It's kind of blindsided. So the past.
Speaker 2 (26:42):
What's your question?
Speaker 3 (26:42):
I think I know where you're going, but what would
you and don't be nervous when we just want to
give you a chance to ask whatever you want, go
right ahead.
Speaker 7 (26:50):
Yeah. So you know, in the past, if an employee left,
we weren't allowed to backfill it. People are working a
lot long hours and we're just like concerned about the
next layoff. We just implemented a new system and people
(27:11):
are working crazy hours and they're in fear of being
laid off.
Speaker 2 (27:18):
Can I ask you question, Mary? Can I ask you
a question? Okay?
Speaker 3 (27:22):
Have they has the management at MGB ever told the
employees what the scope of the layoffs either has been
or will be?
Speaker 7 (27:32):
No? Absolutely not. People are saying, you know, I don't have.
Speaker 3 (27:36):
No idea, You have no idea if the layoffs are
over at this point, right.
Speaker 7 (27:42):
No, So there is supposed to be another layoff in March,
and if you ask a manager, they say, we don't know.
I can't make the decision.
Speaker 2 (27:53):
So, okay, we hear this, this sort of anxiety. I
hear it in you. Do you have a question for
doctor Friedman?
Speaker 7 (28:03):
Well, yeah, no, not I do not, but I wanted
to like express my feelings about the layoffs.
Speaker 3 (28:12):
Well, I want you to know that at least I'm
sure Doctor Friedman joins me in saying that that we
we realize how much, how hard all of you have
worked and I think it's a tragedy that you have
been treated this way if you have not been given,
you know, at least some assurance or given advance notice
(28:35):
that you were going to be laid off, that's no
way to treat employees, to keep people anxiety.
Speaker 7 (28:42):
My comments, but it was one we can hear.
Speaker 2 (28:48):
We can hear the sincerity in your voice.
Speaker 3 (28:49):
Perhaps doctor Freeman would like to comment, Doctor, do you
have a comment for Mary?
Speaker 4 (28:53):
No, I'll like what you said, Dan, Yeah, you and
your colleagues.
Speaker 7 (28:59):
Yeah.
Speaker 4 (29:00):
I mean, I don't have more to say, but that
that does terribly still and unfortunate, and I'm sorry you're
in that predicular.
Speaker 5 (29:08):
Mary.
Speaker 3 (29:08):
I'm so glad that when you listen to my show,
please keep listening and keep us posted as to how
this works out. I'm hoping that you were spared this.
How many years have you worked there? If you want
to tell me roughly, don't tell me precisely.
Speaker 8 (29:23):
Twenty two twenty two years.
Speaker 7 (29:25):
And the people that got laid off for excellent employees,
it was very random, like no rhyme or reason.
Speaker 3 (29:32):
So yeah, and were they were a lot of them
frontline people or were they administrators.
Speaker 7 (29:40):
It's all administrators, but like some vps, some controllers, some managers,
so very random. I guess yeah.
Speaker 3 (29:51):
Okay, well, please hang in there, Mary, and again again
thank you.
Speaker 2 (29:54):
For what you do.
Speaker 3 (29:54):
And I'm so sorry that you're in this feeling of
suspended anxiety.
Speaker 2 (30:00):
I can hear it in your voice. Thank you so much.
Speaker 7 (30:02):
Okay, all right, thank you so much.
Speaker 2 (30:04):
You're welcome.
Speaker 3 (30:05):
You're welcome to take a quick break back with my guest,
doctor John Friedman.
Speaker 2 (30:08):
That was what I was talking about before.
Speaker 3 (30:10):
Doctor Freedman, about the inaccessibility of information not only for
the public, but also for the employees. This is not,
in my opinion, good management style. But that's my that's
my opinion, and I'm not asking to join me on it.
We'll take a break and I will ask you to
stick with us for one other segment and we'll get
more questions. I got Jack and John and Brian and John.
(30:32):
We'll get them all in hopefully between now and ten o'clock.
Coming right back on night Side.
Speaker 1 (30:36):
Now, back to Dan Ray live from the Window World
night Side Studios on WBZ News Radio.
Speaker 2 (30:43):
Back to the phones, we go. Let me go to
Jack in Newton.
Speaker 3 (30:46):
Jack, you're on with doctor John Friedman. He is a
healthcare expert physician as well as an MBA.
Speaker 2 (30:51):
Go right ahead, Jack, how.
Speaker 9 (30:53):
Do you do doctor Freedman? I agree with things you
said there's a shortage, but I would say there's another reason.
My late wife wasn't an obg y n obstetrician pynecologist
from Ukraine, and she had delivered hundreds of babies, but
she was told to go back to school and she
(31:15):
didn't want to. So I blame the American medical societies
for being so strict and having, you know, so little
respect for the medical schools of other countries with the shortage. Excellent, Well, that.
Speaker 3 (31:31):
Gets to a question Jack, we've talked out before about
before as we have so many young, bright people who
are going off short of medical schools a doctor, can
you address That's a point that I think is really good.
When the Jack rays I'm so sorry about the loss
of his wife, could you address that so many young
people go off short when I mean schools outside the
US to earn the medical degrees, and then it's difficult
(31:52):
for them to get back here and get residency. It's
it's it's kind of a crazy situation right now.
Speaker 2 (31:58):
In my opinion doctor.
Speaker 4 (32:00):
Even Yeah, yeah, no, I think you're right. There's a
portion of the American medical colleges and that on the
training programs here in you know, in association with state licensures.
You're right, Jack, really unfortunate, so we only recognize medical
degrees certain countries, Canada, the US, a limited number of
(32:24):
Caribbean medical schools, perhaps a few others that I'm not
sure of, but certainly not your wife. And there are
valid reasons for that, but it's also problematic if people
need to do it. And I've heard many stories of
people who are trained abroad and have to take other,
you know, parafl jobs because they're not qualified lest they
(32:47):
redo their medical education. So perhaps there are things that
can be done along those lines to help increase our
supply of physicians. And of course there needs to be
a trade to make sure that they're well trained. They are,
but why not you're out of way to make that happen,
and go forward, Jack.
Speaker 3 (33:05):
Jack, I appreciate that I got I got three callers
behind you, and you made such a great point. I'm
going to ask if I can move on and get
these other three callers in as well. But thank you
for the points you've made to because it's a very
important point. Thank you, welcome, Thanks Jack, I appreciate. I'll
make it up to you next time. Brian and Pellham,
(33:25):
New Hampshire. Brian, you're next with doctor John Friedman. Go
right ahead, Brian.
Speaker 10 (33:29):
Yeah, I'm a first time caller.
Speaker 2 (33:31):
All right, welcome. We'll give you a lot of applause here.
I'm seeing your audience. Go right ahead, chat, go right ahead, Brian.
Speaker 10 (33:38):
Yeah. So what I have a problem is with every
time you get sick or anything, you have to go
to the emergency room, even even if you go to
a walk in clinic. And I have Crohn's disease, right,
and I get stomach infections a lot. I have blockages
(34:01):
every once in a while, and I'll even you know,
I have to I go to the walk ins and
they say you got to go to the instead of
putting you in the hospital, you have to go to
the emergency room. And sometimes I set in the emergency
room five hours.
Speaker 4 (34:20):
I mean years ago.
Speaker 10 (34:22):
I had a general practitioner which she's retired since.
Speaker 4 (34:26):
And he was great.
Speaker 10 (34:27):
I had him for thirty years or.
Speaker 5 (34:29):
So, and.
Speaker 10 (34:31):
He, you know, if I had something like that, he
would send me right over to the hospital, and now
they say that they can't. What I have now is
a nurse practitioner and she tells me that she can't
do that. Everybody has to go through the emergency room first.
Is that am I correctness?
Speaker 4 (34:51):
I think that's the way it's become. Brian and well,
I'm really sorry to hear that Chrome's disease can be
a terrible condition, and it can be very complex, and
sitting in an emergency room.
Speaker 5 (35:04):
I hate to say it.
Speaker 4 (35:05):
If you've been there for five hours, maybe you were lucky.
There are too many stories of people who spend more
time than that. Yeah, many hops are so overcrowded that
they force a urgency room. And I think efficiency and
the lystics of how we're practicing medicine have, sadly, in
(35:26):
some ways, just gotten worse. This is what I try
to professionally. We work with a lot of state health agencies.
I'm trying to make health care better, but it's been
really hard. So I think your observation is on track,
and sadly.
Speaker 2 (35:43):
I wish we had a better answer for you.
Speaker 3 (35:45):
But you've raised the issue and I think it's an
important one, and I agree with you totally thank you
for calling you.
Speaker 2 (35:51):
I look forward to your next call. Thanks, Brian, appreciate it,
Thank you, take care, good night.
Speaker 3 (35:55):
Let's go to We have two Johns in Boston, so
John and Boston go right ahead.
Speaker 8 (36:01):
Basi and doctor Freeman's quick thank you, just quick question.
I was talking to a medical professional. This week's kind
of upsetting. A childhead a tumor went to Mass General
supposed to get read some kind of treatment for his
brain tumor. He had a schedule appointment, an appointment was postponed,
rescheduled for a child who's and this child is a
US citizen, for a non US citizen child to come
(36:24):
in and get treatment in his in his place. And
I'm just wondered, is that a common practice. It was
just upsetting that a US child would schedule the pointment
would be moved out for a child from who's a
non citizen. I'm just wondered that was a common joh
And I don't.
Speaker 3 (36:41):
Know how doctor Freeman could even address that because he
has h you know, no, doesn't understand the situation. Doctor Freeman,
I I can take you off the hook here, but
because I don't know that you're able to address a
specific set of circumstances like this. I don't think it's
probably something that happens frequently. You want to comment at.
Speaker 4 (36:59):
All, and well, uh, just to say that I, yes,
I think this was quite an unusual thing. Be more
than just verify exactly what happened, because that does not
at all sound like the sort of thing that normally happened.
Of course, I have no idea what happened.
Speaker 3 (37:18):
Any child who's in for treatment for a brain tumor
should should ever be uh should have his his his.
Speaker 2 (37:25):
Treatment postponed for any reason whatsoever.
Speaker 5 (37:27):
John, Okay, No, I appreciate it.
Speaker 8 (37:30):
Uh, this person was upsets, very upset.
Speaker 2 (37:34):
So again we're talking about a.
Speaker 3 (37:37):
Senate circumstances we know nothing about. And so therefore I'm
just gonna let you go for now and gry to
get one more call in him before the hour.
Speaker 2 (37:44):
sOliver.
Speaker 3 (37:44):
Thanks, John, appreciate it. Let me go to the other
John in Boston. John, and Boston, you were next one. Nice,
I go right ahead.
Speaker 5 (37:51):
Thank you, damn doctor, thank you doctor. God most result. Yeah,
it's a it's a shame because uh, with gentlemen just said,
the layoffs not being given their heads up, and you know,
we were known as probably one of the best places
in the world were coming. I'm not being biased because
of Boston. You know, I was born and race here,
(38:13):
but that other than California and Florida. But that's being said.
You know, you don't want to bring politics in it,
and I can't understand that. I know hospitals that were
given sinus ten thousands of new employees, nurses, and I
just listened. I didn't say a word right in Boston,
and then some of them were leaving after a month,
six months, a year, and I said, wasn't in a
(38:35):
situation put in this, No, not at all. But yet
the people that have been there twenty thirty what years?
What were they given?
Speaker 2 (38:43):
Yeah?
Speaker 3 (38:43):
And again, John, we have no way of knowing. I'm
sure what you're telling us is the absolute truth. But
I don't know that Doctor Friedman could comment on on that.
Speaker 2 (38:51):
Have you ever heard that before? Doctor Freeman?
Speaker 4 (38:53):
Well, yeah, I can't from that physic thing. But let
me make it. I'm on a broader point that I make, John,
which is about pride in the hospitals and the quality
of Boston. Remain very proud of the excellent care. We
have a number of really outstanding centers in addition to
mess you know at Real Laty Clinic, Toughs Medical Center,
(39:16):
Boston Medical Center Center, We've got a whole bunch of
elite places to get care. So that means we'll still
remain focus of it. I think a danger have is
that not just in Massachusetts, but around the there's been
a lot of merger consolidation. Certainly we've seen with the
(39:38):
the of mass Journal, Brigham particular, also the Lady Network,
and again I'm not going to comment on them specifically,
but when you look at the data hospital mergers around
the country, when they merge, the costs go up, and
while in the service do go up, and fortunately, damn, it's.
Speaker 3 (40:01):
Just unfortunately, gentlemen, I've got to bring it to a
close here because we're actually now brushing up against the
ten o'clock newscast. Doctor John, thank you for the call
and comment. And doctor Freeman, thank you very much for
your tonight. Really do appreciate it, and I'd love to
have you back at some point.
Speaker 4 (40:18):
Okay, it would be my pleasure. Dam Thanks so much,
Thanks so.
Speaker 2 (40:22):
Much, really thank all the conversation.
Speaker 3 (40:24):
All right, thanks, when we get back, we're going to
change topics. Those of you who are calling in now
are a little late. We'll change topics and we're going
to talk about little politics in the ten o'clock hour
back after the ten
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