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This article by was prepared for the June 11, 2003 edition of U.S. 1 Newspaper. All rights reserved.
Life in the Fast Lane
Downtown Princeton was able to hold onto its library,
but it may someday lose its hospital. For now, though, Princeton Borough
— which is overseeing the library’s demolition and reconstruction
after it had considered moving to the adjoining Princeton Township
— just has to adjust to a hospital with a different name. The
Medical Center at Princeton, still referred to as “Princeton Hospital”
by many, is now the University Medical Center at Princeton. A new
logo goes along with the change, as does an altered strategy.
Bruce Traub, vice president of finance of the hospital, says that
an enhanced affiliation with the University of Medicine and Dentistry
of New Jersey, the highest level of affiliation the institution affords,
is part of that strategy. Princeton has long been a teaching hospital,
but, he says, it is not always perceived as such. “There are benefits
to receiving care at a teaching hospital,” he says, “and we
are not always recognized as being a teaching hospital.” In fact,
Princeton has long had UMDNJ residents on its staff, and now has 33,
a number that will grow under its new relationship with the medical
school.
Princeton also hopes that its new plan will grow its inpatient population.
Its goals include increasing emergency room visits from 36,000 to
42,000; upping surgical volume from 2,500 to 3,600 patients; and delivering
some 700 additional babies. Marketing will be important in accomplishing
these goals. “We have the beds,” says Traub. “I think
we can do a better job of letting patients know what we do here.”
Toward that end, $750,000 has been allotted to develop and spread
the word about the medical center’s new identity.
Physician recruitment and better coordination of insurance coverage
are two more steps along the way to full utilization. “Over the
next three or four years we will need 45 more physicians,” says
Traub. Recruiting is a long process, he says, made more difficult
by the scarcity of doctors in some specialties and by New Jersey’s
high malpractice rates. Initially, Princeton plans to retain a recruiter
to help with the task. As for insurance, it often determines where
a patient will elect to have a procedure. Getting more physicians
to accept payment from the insurance companies from which the hospital
accepts payment is important, and Princeton made a big move in that
direction on June 1.
“The biggest payor is Aetna,” says Traub. “On June 1,
our physicians’ organization signed with Aetna.”
Princeton is not alone in having empty beds. There are 83 hospitals
in the state, says Ron Czajkowski, spokesman for the New Jersey Hospital
Association, and at the end of calendar 2002, they were running at
74.5 percent capacity in maintained beds — those that are made
up and ready to go, as opposed to those in closed-off wings. “That
doesn’t mean that our hospitals are not very busy places,” he
hastens to add. Even with 25 percent of beds unused, intensive care,
oncology, and cardiac “could be at 100 percent week after week.”
Still, 83 hospitals competing in one of the smallest states in the
union, and one that is bookended by two cities chock-a-block with
famous medical facilities, means that each hospital has its work cut
out, and not just in attracting patients who will be needing beds.
“Three or four decades ago,” says Czajkowski, “patients
came in sick and went home seven days later.” Now, those who arrive
packing tooth brushes are home again in an average of four days. For
many, the stay is so short that “drive-by” operation does
not seem to be a complete misnomer. “The classic example is cataract
surgery,” he gives as an example. “Thirty years ago, you were
in for 10, 12 days. Now, you’re in at 9 a.m. and home in a recliner
by 2 p.m.”
Outpatient services have exploded, and changed the very
nature of a medical center. “In 1990,” says Czajkowski, “there
were 7 1/2 million outpatient procedures done in New Jersey. In 2000,
it was 13 million.”
Given this shift, it is not surprising that Princeton’s plans include
a big, new emphasis on outpatient and preventative services. A centerpiece,
the Medical Center at Princeton Fitness & Wellness Center, a full-service
gym and rehabilitation facility, just celebrated its grand opening
on Route 206 in the Princeton North Shopping Center.
Under its new identity, Princeton is calling attention to other off-site
facilities — many of which have been around for years — by
renaming them to emphasize the connection. Princeton House is now
Princeton House Behavioral Health, and HomeCare Services is now Princeton
HomeCare Services.
The biggest change of all could be the end of a downtown hospital
for Princeton. “We’re landlocked,” says Traub. Sitting on
a nine-acre site, the hospital sees no way to expand significantly.
Even if the Princeton Packet, occupying one large and several small
buildings across the street in one direction and a good-sized parking
lot in the other, should suddenly decide to sell (not so far-fetched
considering that the Packet once weighed moving its printing presses
to a spacious South Brunswick location), it would not be enough. “Someone
on the staff suggested that,” Traub says with a laugh. A suggestion
to approach Princeton Township about land it owns a little farther
down Witherspoon Street has been floated too.
But, says Traub, even if nearby land should become available it would
not change the fact that “Witherspoon is a narrow street.”
It is not easy for ambulances to get through town and down to the
hospital via Witherspoon, and he says that navigating trafficky Route
206, which runs parallel, is not much easier.
Princeton is looking for new space on which to build a large outpatient
facility. It is not impossible, says Traub, that its inpatient services
could move to such a new facility, too. But what the draw of the Princeton
location at which so many Princeton area folks were born and gave
birth? Traub acknowledges the importance of the Princeton connection,
and says that any new facility would be close by. The borough, lacking
as it is in large parcels of empty land, probably is not an option,
he says, but the township is. And the medical center, says Traub,
is indeed looking at land in the township.
Robert Cimasi, president of St. Louis-based Health Capital Consultants,
a healthcare consulting group, is not surprised. “We do a lot
of work in Mercer County,” he says. “Things are moving pretty
quickly. Look at the other facilities in the county that don’t have
beds, but provide outpatient services — cancer, surgery, rehabilitation,
a lot of things that used to be in-patient.” Outpatient services
is the direction in which health care is moving.
It is the same in St. Louis as it is in New Jersey. The city has one
of the top three teaching hospitals in the country, Washington School
of Medicine, says Cimasi, but the hospital connected with it had to
change substantially to survive. “Washington U is connected to
Barnes, which has had to merge with many others,” he says. “It
had to get out in the community.”
The pressures that are driving Princeton, and every other hospital,
in Cimasi’s view, include technology, paltry reimbursement, and a
clueless federal government. “If you had a brain tumor, would
you settle for an X-Ray?” asks Cimasi. His tone makes it clear
that this is a rhetorical question. “No, you would want a 3D MRI.”
Obtaining such a machine is wildly expensive in any case. Obtaining
one in New Jersey, a highly-regulated state where hospitals have to
show a need for such tools may be impossible.
On the other side of the coin, it is possible to obtain an approval
for a device or a procedure, spend millions to put it in place, and
then see newer technology reduce its benefit as a revenue generator.
An example is open-heart surgery, a program Princeton does not have
and is unlikely to get. Hospitals able to provide this procedure have
found it to be a major profit center in an increasingly unprofitable
industry. But, zooming along, as is its wont, technology has now produced
devices — drug-coated stents to keep blood flowing smoothly through
clogged veins and arteries — that stand to substantially cut the
need for open heart surgery.
If rapidly-changing technology makes planning difficult, it is nothing
compared with the havoc wrought by the government. “I’m going
to be in Washington this week,” says Camisi, who is getting set
to appear on Capitol Hill to testify to lawmakers about healthcare
reimbursement. “I’m not sure anyone is steering the ship,”
he says.
In 20 years of involvement in the healthcare industry, Camisi says,
“I have never seen times as uncertain as they are now.” Congress,
by cutting reimbursement under Medicare and Medicaid, has all but
killed the home care industry, he says. Most hospitals, including
Princeton, derive half of their revenue from the two programs. Further
cuts, in Camisi’s opinion, would be devastating. “Princeton could
do everything brilliantly,” he says, “but with one stroke
Washington could wipe it out.”
But given the battle that Princetonians put up for their library,
Washington could be the least of the University Medical Center at
Princeton’s problems should it decide to decamp from Witherspoon Street.
— Kathleen McGinn Spring
The wheels turn slowly, but they keep turning. Progress
has been made on the plans to alleviate traffic jams on Route 1 —
and on roads that feed into Route 1 — in the Penns Neck area of
West Windsor.
After the DOT’s initial preferred alignment for a Millstone River
bypass was decried by opponents as an environmentally-harmful fait-accompli
presented with little community input, a roundtable approach was initiated
by then governor Christie Whitman. The Voorhees Transportation Policy
Institute of Rutgers University, operating at the request of the New
Jersey Department of Transportation, organized a Partners Roundtable.
Its 32 members represented sometimes conflicting community, historic
preservation, environmental, corporate, retail, and government constituencies,
and they came up with seven road-based alternatives for the five-mile
radius around the Route 1 and Washington Road intersection in the
Penns Neck section.
Diagrams of the seven alternatives were presented to the public on
September 30, 2002. Now the required full-scale environmental impact
study (EIS) is ready. Public hearings on the EIS will be held Monday,
June 30, at 11 a.m. and 7 p.m. at the New Jersey Hospital Association
Conference Center, 760 Alexander Road. If needed, the public hearing
will continue on Tuesday, July 1, from 7 to 11 p.m. at the West Windsor
Township Municipal Complex, 271 Clarksville Road.
EIS materials for review are available now at six locations, including
the clerks’ offices of Princeton borough and township and the public
libraries in West Windsor and Plainsboro. Materials will also be available
on the day of the hearing from 10 a.m. to 11 p.m.
Those who wish to make a presentation at the hearing are encouraged
to make an appointment by calling in advance to Andrea Lubin at 732-932-6812,
extension 593, but appointments can also be made at the door. Written
statements received by Friday, August 1, will be made part of the
record. Statements or appointment requests can also be sent to Rutgers/Voorhees
Transportation Policy Institute, 33 Livingston Avenue, New Brunswick
08901, or faxed to 732-932-3714, or E-mail: cdanku@rci.rutgers.edu.
Synnestvedt Lechner & Woodbridge LLP, 112 NassauStreet, Box 592, Princeton 08542-0592. Richard Woodbridge, president.609-924-3773; fax, 609-924-1811. Www.njiplaw.comDick Woodbridge has merged his four-attorney intellectual propertylaw practice, Woodbridge & Associates PC, with a 106-year-old firmin Philadelphia, one of the oldest full-service intellectual propertylaw firms in the country. “We considered merging with large generalpractice firms in the past,” says Woodbridge, partner in chargeof the Princeton office, “but came to the realization that, froma cultural and practice standpoint, our clients would be best servedby joining with a well-established, independent IP firm, such as Synnestvedt& Lechner.””The continued growth of technology-based companies in New Jersey,particularly in the life sciences and specialty chemical fields whichare traditional strengths of our firm, warrants our expansion intoNew Jersey,” says Al Barron, managing partner.The Philadelphia office did not change its name, but the Princetonoffice uses the combined names. Woodbridge and Associates has expertisein computer, electronic, and software fields as well as in trademarklaw.Top Of PageManagement MovesGreater Mercer County Chamber of Commerce, 214West State Street, Trenton 08608-1002. Cathy Frank-White, CEO. 609-393-4143;fax, 609-393-1032. Home page: www.mercerchamber.orgCiting the need for a less demanding job, Cathy Frank-White announcedshe will retire as president of the Mercer Chamber on July 1. Herresignation was not expected, and she will remain as a part-time consultantwhile the board conducts a search for her successor. Having increasedthe membership rolls by 20 percent, from 900 to nearly 1,100 businesses,Frank-White leaves the chamber in a stronger position than when shearrived in 1999.When Frank-White took the job as president and CEO of the GreaterMercer Chamber, she was starting her fifth career. A graduate of MontclairState with a master’s degree from the College of New Jersey, her firstjob was teaching high school and middle school. Successive jobs wereas administrator of Township of Branchburg, executive director ofthe New Jersey Chiefs Association, and manager of government relationsfor Wakefern Food Corporation and Shop Rite.When she came to the chamber she made it a point to personally visiteach and every business that called her office to spend time explainingwhat the chamber could do for them. She also instigated expansioninto new areas of the county, most recently Hopewell.Princeton Theological Seminary, 64 Mercer Street,Princeton 08540. Thomas W. Gillespie, president. 609-921-8300; fax,609-924-2973. Home page: www.ptsem.eduThomas W. Gillespie will retire as the seminary’s fifth presidenton June 30, 2004. During his 10-year tenure the seminary completedtwo major capital campaigns.Top Of PageStock NewsFirst Washington State Bank (FWFC), Route 130 andMain Street, Windsor 08561-0500. C. Herbert Schneider, CEO. 609-426-1000;fax, 609-426-9624. Www.fwsb.comFirst Washington FinancialCorp, holding company for First WashingtonState Bank, hopes to move its stock from the OTC Bulletin Board tothe NASDAQ SmallCap Market. It expects to receive approval for thelisting by early summer.With 125 employees in Central New Jersey, the bank has 12 branch officesand is a joint venture partner in Windsor Title Agency LP. It hasreceived approval for a new branch at the ShopRite in the MercerMall.Top Of PageDeathsGeorge A. Ford, 57, on May 28. He had worked for RCA andas equipment manager for the Lawrenceville School.Victor P. Kozak, 70, on June 3. He owned Ultimus FishingProducts in Lawrenceville.Thomas “Kirk” Finney, 53, on June 3. He was acook at Cloister Inn in Princeton.Sandra Lee Jefferis Wagner, 58, on June 5. She taughtat the Waldorf School of Princeton.Robert Calvin Gaver, 64, on June 7. He was a cancer researcherat Bristol-Myers Squibb.Chen Do Yu, 60, on June 7. He was a manager at CVS Pharmacy.Eugene C. Sersen, 45, on June 8. He worked at the U.S.Post Office in Princeton.Corrections or additions?This page is published by PrincetonInfo.com— the web site for U.S. 1 Newspaper in Princeton, New Jersey.
