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Dartmouth-Hitchcock CEO: Area Needs Workers (Video)

  • Joanne Conroy, CEO of D-H, speaks with the Valley News editorial board at the Valley News in West Lebanon, N.H., Jan. 16, 2018. (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Valley News — James M. Patterson

Valley News Staff Writer
Published: 1/17/2018 12:07:55 AM
Modified: 1/18/2018 9:30:00 AM

West Lebanon — What tops the list of concerns for the CEO of New Hampshire’s sole academic medical center and largest private employer?

Dartmouth-Hitchcock CEO Joanne Conroy said she worries about having enough people to deliver health care to the region’s aging population. She expects these workforce needs will continue to grow until 2025.

“When we look at our projections, it’s going to get worse before it gets better,” Conroy said during a meeting with the Valley News editorial board on Tuesday.

Challenges to the recruitment and retention of employees include a dearth of affordable housing, limited public transportation options, the increased demand on services — particularly schools — that growing the population in the center of the Upper Valley might have, and a lack of activities such as nightclubs geared for 20-something employees, said Conroy, who has been D-H’s CEO since August.

Addressing the health care needs of an aging population also may require changing the way health care is delivered, Conroy said.

As part of that shift, Conroy said, she has been in talks with Alice Peck Day Memorial Hospital’s CEO Sue Mooney about setting up an emergency department specifically geared for geriatric patients at APD, the D-H affiliated community hospital in Lebanon.

D-H cannot tackle its workforce issues or the health care needs of an aging population on its own, Conroy said. Addressing them will require collaboration between employers and communities, she said.

As with a public health challenge such as the opioid epidemic, it “can’t be like, ‘Here’s the solution,’ ” Conroy said.

Instead, she said, D-H officials “have to build community coalitions that really want to work on these complex problems.”

Workforce solutions may include building additional housing units on D-H property, adding a D-H bus route for those commuting to Lebanon from southern New Hampshire, changing the way health care is provided by shifting some care from the hospital to home settings, and in some cases, replacing people with technology.

When she asks employees why they are driving as much as an hour and a half each way to work at Dartmouth-Hitchcock Medical Center, Conroy said, a lot of times they tell her it’s a lack of affordable housing closer to Lebanon.

Adding housing units to D-H property or property jointly owned by D-H and Dartmouth College is a topic of active discussion and something Conroy said she has seen work elsewhere.

Morristown Medical Center in Morristown, N.J., where Conroy once worked as president and chief operating officer, had 350 housing units located on its property behind the hospital. Some of these units were kept affordable through the Section 8 voucher program funded by the U.S. Department of Housing and Urban Development, she said.

“They were (offering) affordable housing even for people who were not employed there,” she said.

Developing housing on D-H’s property is not something the health care system would do on its own, Conroy said.

“We need partners because we’re not a construction company,” she said. D-H officials also “need to be sure that we’re building something that people actually want.”

D-H currently benefits from a bus route — operated by The Current — that includes a stop at a park and ride in Springfield, Vt., and brings people to DHMC’s front door, Conroy said. She’s heard feedback from employees that the service eases the burden of the commute, which she said also might help employees commuting from the Manchester area.

In addition to making it easier for people to work at D-H, Conroy said it’s also possible that some tasks those employees now perform, such as vacuuming and scheduling, might be turned over to robots. The employees would not be displaced but made available to perform other work, she said.

Even if technology is employed, Conroy said, there are many aspects of health care delivery that have to be done by a human being.

“I’m not sure we’ll ever have the supply of health care workers that we need,” she said.

Thinking as a System

Addressing aging patients’ needs may require shifting the location where care is delivered, Conroy said. So, instead of providing inpatient care in a hospital, there is a growing demand for delivering care at home. Doing so will require boosting the home health care workforce and increasing the number of care coordinators to communicate between hospital-based clinicians and those providing home care, she said.

An emergency department focused on geriatric care at APD, which would address the needs of older people in a less chaotic setting than a traditional emergency room and draw on APD’s expertise in caring for older adults, is an example of one of the advantages of a multi-site health system, Conroy said.

Another area where the system can be improved as the population ages is oncology, Conroy said. Because D-H providers are treating older cancer patients and survivors, oncology is a top priority for both clinical and research appointments, she said.

Getting D-H employees and those of its affiliates — which in the Upper Valley, in addition to APD, includes Mt. Ascutney Hospital and Health Center, New London Hospital, and Visiting Nurse and Hospice for Vermont and New Hampshire — to think as part of a system is one of Conroy’s goals, she said.

As the current affiliates learn to work together effectively, D-H — which has outpatient clinics in Manchester, Nashua and Concord — continues to seek a suitable partner in the southern part of the state, Conroy said. It is too soon for her to speak publicly about any specific discussions, she said.

“We probably will align with a partner,” she said. “Somebody who shares our values (and has a) similar commitment to quality and cost.”

The partnership may be, at least to start, more of a clinical collaboration than a full merger, she said.

“I think you should date before you get married,” she said.

Specifically, such a clinical collaboration would include care managers tracking D-H patients in the southern part of the state who land in an emergency room.

“We probably know what that patient needs better than an emergency room physician that’s never seen that patient,” she said.

Nora Doyle-Burr can be reached at or 603-727-3213.

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