Stephen Newman M.D.
Management
This is Steve. With respect to El Paso, we have not seen a significantly negative impact on our inpatient and outpatient volumes in El Paso related to the employment level. On the contrary, with the base realignment program and expansion of Fort Bliss, we’ve seen a significant growth, especially in the northeast quadrant of the city with civilians there to support the activities at Fort Bliss. That has really helped us ramp up the east side new hospital in terms of its volume. We have completed the specialty medical staff there; although we are continuing to recruit primary care and we’re pleased with that performance as well as the overall performance of the market. We’ve made some intricate changes in the market, not at the CEO level, but in the A teams, and expanded our physician recruitment and physician relationship program staff, so we’re feeling a very positive momentum now with our El Paso market. With respect to Coastal, Coastal as you know is a small hospital that has a very concentrated small, active medical staff. We’ve had some physicians move out of the area, our of state and we’re in the process of recruiting to back fill that, but clearly its collaboration with our Hilton Head Hospital is increasing. We have Hilton Head physicians covering the Coastal Carolina significant services like general surgery and orthopedic surgery now, and we have signed some letters of intent with specialists in those two areas for them to relocate to the Coastal Carolina, Hardeeville area shortly. With respect to unemployment around the country, as Biggs said, we’ve got a mixed picture and some of our markets with the highest unemployment rate we’re continuing to grow volume and grow commercial volume in comparison to Q4 ’07. In other we see a more significant delay in elective surgical procedures. It is sort of interesting, as you look around the country, our ER visits I the quarter were down compared to Q4 ’07. On the other hand, our admissions that come through the ER are actually increasing. So, what we’re seeing is that less seriously ill patients are not coming to the emergency room. Now we can speculate on why that’s happening, but one thing is those that were previously commercially insured may elect to find care when they need the sort of less serious care at other clinics, or even at private doctors’ offices, rather than coming into the ER. As Biggs said, we’re following the situation closely, we’re ramping up our efforts to take market share in all of the markets, especially in our TGI priorities, as well as our commercial managed care area, we’re expanding our business to business activities in terms of growing that commercial business and we’re optimistic we’re going to make progress in 2009.