District1199NM
District1199NM
National Union of Hospital and Health Care Employees
 

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    Listening to Our Health Care Providers
    December 21, 2021

    Listening to Our Health Care Providers: What We Learned from the Third Meeting in the Health Security Plan Design Series

    On Saturday, December 11, we hosted a very interesting virtual panel of health care professionals from a variety of practice areas in New Mexico.

    Their purpose: to describe the administrative frustrations they face every day that impact patient care and contribute to burnout. Watch the recording here.

    To fix this broken system, we need to have a full picture of what the problems are. The panelists and additional contributors helped to draw out some of these serious challenges, and we are grateful for their participation and their willingness to share their experiences and insights.

    Our next session in the Health Security Plan Design Series will explore different provider payment methodologies that may help to solve the problems health care professionals and patients now face. We will let you know as soon as it’s scheduled.

    What We Learned: Administrative Hassles That Impact Patient Care

    Some of the issues that came up again and again in the meeting were:

    • time-consuming prior authorizations for tests, procedures, and referrals

    • constantly changing formularies (lists of which procedures and medications a particular insurer will cover)

    • billing codes that do not reflect the level of complexity in medical encounters, particularly in behavioral health, where the same billing code is used for relatively simple cases and for extremely difficult and complicated cases

    • higher pay for procedures than for time spent problem solving and counseling patients

    • complex bill coding systems that require coding specialists to properly file for reimbursement and that can be manipulated to maximize payments

    • inequality of payments for family practice practitioners v. specialists, and for nurses and nurse practitioners v. physicians who are doing the same procedures

    • opaqueness and instability of pharmaceutical pricing, and the outsized role of pharmacy benefit managers (companies that manage insurers’ prescription drug programs)

    • pay-for-performance programs and quality-of-care metrics that have high financial and time costs but do not serve individual patients well

    What We Learned: The Effect on Patients

    All of these issues have a real impact on patients:

    • Patients struggle to get the care they need, waiting for prior authorization from their insurer before they are able to see the specialist that their health care provider has referred them to, or get the test or medication that their health care provider has prescribed.

    • Patients are too often unable to afford the pharmaceuticals they are prescribed, or need to constantly switch their medications because of which drugs their insurer covers that month.

    • Patients may never get the chance to have an in-depth conversation with their provider, who is incentivized to offer (and bill for) a procedure rather than sit down and initiate a life-changing discussion that could help a patient change their daily habits to benefit their health.

    There were many more issues discussed during the meeting. We encourage you to watch the recording to learn more!


    The December 11 meeting was moderated by Donna Dowell, CNP, a certified nurse practitioner in Placitas.

    The panelists:

    • Danny Cross, RPh, independent pharmacist in Carlsbad

    • Kathy Fresquez-Chavez, DNP, FNP-C, MSN, independent provider in Valencia County

    • Lara Goitein, MD, pulmonary and critical care physician in Santa Fe

    • Rick Madden, MD, family physician in Belen

    • Thomas C. Thompson, PhD, MP, ABN, ABMP, clinical and neuropsychology-prescribing psychologist in Las Cruces

    Additional health care professionals who attended the meeting also spoke about the challenges they encounter. Gloria Doherty, PhD, MSN, RN, ACNP-BC, talked about several issues facing nurses and nurse practitioners, as well as larger issues in the system; Bernadette Luján, DOM, shared what she experiences as a doctor of oriental medicine; and Ricardo Gonzales, PhD, contributed the challenges he sees as a clinical psychologist practicing in northern New Mexico.


    District1199NM received T-shirts for union members.  Sizes range from Small to 5X, please stop by the office Monday thru Friday, between 9 AM and 5 PM for your T-shirt and wear it with pride!  Please call before you drop by - just to be on the safe side.


    By AFSCME Staff ·

    When Maryam Chudnoff was 18, her baby daughter had a seizure.

    “She wasn’t breathing, and I lived in a rural community in northern New Mexico where even if you call an ambulance it was going to be, you know, at least 45 minutes for them to get out to you,” she recalls.

    Chudnoff performed mouth-to-mouth resuscitation and saved her daughter’s life. But she knew there would be other emergencies.

    That’s when she knew what she had to do. She took a first aid class, and that was the beginning of her career in health care.

    “I don’t think I ever really had a choice for anything else other than health care,” she says.

    After serving in a nursing home and getting her EMT license, as well as working in a pediatric emergency room and in labor and delivery, among other jobs, today Chudnoff is a registered nurse at the University of New Mexico Southeast Heights Family Practice Clinic in Albuquerque.

    “As a registered nurse in the family practice clinic, we take care of everybody in the community,” she says.

    But Chudnoff has found other ways of making her community better. With the help of the Islamic Center of New Mexico, she and several other women established a food distribution center for people in need.

    “As Muslims, we have a great tradition of charity, of giving back to our community,” she says. “We collect donations, and everything that we collect goes right back into the community. … We have several patients from the clinic that now come to the food distribution.”

    Her supervisor at the clinic, Pilar Montero, says Chudnoff’s commitment to the community has inspired many others.

    “She’s just such a leader and a great guide to doing the right thing,” Montero says.

    A member of the National Union of Hospital and Health Care Employees (NUHHCE), District 1199NM, AFSCME, Chudnoff is a winner of our union’s Never Quit Service Award, which seeks to recognize public service workers who go above and beyond the call of duty to make their communities better.

    “It’s been pretty amazing to hear people’s stories,” Chudnoff reflects. “One patient told me, ‘Oh, I came to the food distribution. I got so much food there I went and I gave it to two of my neighbors and had somebody else over for dinner.’ And it was just that ripple effect, right? From this one person coming in and getting food, she shared it with several other people, and not just the food but the energy, the thought, the love. It also spread in the community.”

    What motivates her to serve, Chudnoff says, is a sense of responsibility, but also “overwhelming love and passion for my community. … I can’t imagine not doing things that benefit others.”  Watch Facebook video here.


    After a 12 hour shift on the COVID-19 unit at work, NUHHCE District 1199NM members share their personal story. These powerful videos share exactly what New Mexico is facing with the ongoing pandemic and why wearing a mask, social distancing and taking other steps to fight back against the coronavirus are so necessary.

    We have risen to the challenge – will you?


     


    Martha Jaramillo - Holy Cross Hospital, Taos, New Mexico

    Full Video

    30 Second Video

     


    Nick Armijo, Christus St. Vincent, Santa Fe, New Mexico

    Full Video

    30 Second Video

    30 Second Video Alt

    15 Second Video 


    Suzanne Bell  - University of New Mexico Hospital, Albuquerque, New Mexico

    Full Video

    30 Second Video

    15 Second Video



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New Mexico Hospital Workers Union
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