Meharry Medical College has decided to take a leading role in the future of Nashville General Hospital, organizing a working group that includes the administration of Mayor Megan Barry, school officials, ministers and labor leaders representing hospital staff.
This follows a few weeks of uncertainty after school announced this month it will relocate its third- and fourth-year medical students to an HCA hospital because business at Nashville General is so slow.
At the same press conference where Meharry said it was switching hospital affiliations, Mayor Megan Barry announced her intention to eliminate inpatient services at Nashville General. But she faced swift blowback for not having broad outline of what that restructuring would look like.
"My announcement was the starting point for our discussion," Barry said in a letter to the Metro Council. "Now it is time for all involved to work together to develop that proposal into a workable and sustainable reality."
In an interview with WPLN, Meharry president James Hildreth says *he can see the potential benefits of Barry's proposal to refocus on outpatient services, adding that most physicians will work in an ambulatory setting once they get out of school.
Even though Meharry has now agreed to send students to HCA's Southern Hills Medical Center, Hildreth says he could see each of them spending a rotation at Nashville General as an outpatient facility.
"The whole purpose of medicine now is to keep people out of the hospital," he says. "So one of the big changes in how we train students and treat patients is this shift toward ambulatory patients, rather than inpatient."
Whatever happens, Hildreth says, Meharry will be involved, especially since the facility is on campus. The school still owns the building, which is the old Hubbard Hospital.
"I think we're well positioned to elevate the conversation — we can't undo what's been done — and move forward. That's really what I want. I just want us to move forward," Hildreth says.
The hospital has almost always struggled, and not just because most of its patients can't pay. Currently it's operating at just one-third of capacity.
But while 90 percent of visits are already outpatient, ending inpatient care means answering some difficult questions, like where prisoners will get treatment, and what happens to the hospital's staff.
Even some members of the Nashville Hospital Authority, which governs General Hospital, have acknowledged that something must to change. The facility has required a mid-year infusion of cash annually, even while treating fewer patients. But until Meharry's announcement about relocating medical students, there had been no urgent conversation about serious restructuring.
"I can't speak to whether the conversation would have happened [otherwise]," Hildreth says. "What I can say is that we believe Meharry is in the best position now that we are where we are to help organize and lead an effort to find the best model."
*This line has been revised for clarity.