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Fiscal woes hit hiring at TGH

June was not a good month for Tampa General Hospital's bottom line, so July became a bad month for 77 people who thought they had new jobs at the hospital.

The fiscal environment at the public hospital took a turn for the worse in June with a significant drop in cardiology patients. Hospital officials said a shifting of patients by managed-care companies contributed to a $4-million loss in June.

TGH could be facing a $3.7-million loss for the fiscal year ending Sept. 30, said Kathryn Gillette, the hospital's chief financial officer.

Cardiology admissions dropped by 69 patients from May to June, said Gillette. There also were fewer patients in the hospital's "cath lab" _ an outpatient cardiology service. The loss of those patients has a ripple effect on other parts of the hospital, she said.

Gillette said she could point to no single reason why managed-care companies and some doctors' groups were moving patients elsewhere.

"The motivation may not only be the price we charge," said Gillette. "There's a whole host of reasons why managed-care plans might direct patients elsewhere."

Gillette said the hospital also did not trim expenses in June to adjust for the drop in the patient census. Faced with an unexpected budget shortfall, hospital president Bruce Siegel ordered job offers withdrawn last week.

"Hiring almost 80 people in this fiscal environment is not a good idea," Siegel said Tuesday.

One Tampa cardiologist, Dr. Kiran Patel, said insurance and managed-care companies have been gradually shifting his patients away from Tampa General.

"Unless you are cost effective you are going to lose business," Patel said.

Gillette said Tampa General's prices are in line with other hospitals, but said some other hospitals might keep patients for shorter stays, or order fewer tests.

As patients are shifted to other hospitals, doctors follow. "Physicians are going to go where the bulk of their patients are," said Gillette.

Siegel has met with physicians groups that direct patients to Tampa General in a bid to keep current business and reclaim some lost business.

Siegel, who became hospital president in July, said he is changing the way Tampa General does business. "We've got to become real conscious of the bottom line," he said. "We're under intense pressure to bring costs down."

Still, Siegel said he has not imposed a hiring freeze. "We will hire those people who are essential to our mission and essential to the quality of care we provide," he said.

With fewer patients and a significant drop in revenue in June, Siegel said he could not justify the 77 new jobs. Of those, 52 were full- or part-time. The rest were freelance jobs that did not include employee benefits.

Siegel said he wanted to make the decision before the employees started work, rather than laying them off in a few weeks or months.

"I'd rather make that decision now than later," he said.

Siegel said he knew his decision had a human cost. Some of the new employees had left other jobs and at least three had relocated to the area, said Mary Ann Knight, a hospital vice president. She said the hospital is trying to find other jobs in the area for those workers.