South Florida Hospital News
Tuesday December 10, 2019

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July 2007 - Volume 4 - Issue 1



Miramarís Fernandez Targets Familiar Health Care Challenges

Unless there are some dramatic changes in the business of health care, Aurelio Fernandez will be facing familiar challenges in the future, as will most, if not all, providers in Florida and across the United States.

"Our problems are not really different than anyone elseís. The healthcare industry has been taking it on the chin in a number of ways," Fernandez, who was named chief executive officer and administrator for Memorial Hospital Miramar in May, said.

Memorial Miramar is one of five hospitals operating under Memorial Healthcare System, the public, non-profit health care provider in South Broward County.

Among the lingering difficulties confronting the medical community, Fernandez said, are inadequate reimbursement from managed care providers, excessive capacity, and a litigious environment fueled by "lawsuits without basis," Fernandez said. The latter problem lies with the medical liability insurance crisis.

"Many physicians have left our state and it is difficult to retain current staff or recruit new doctors," Fernandez said.

While acknowledging that Florida officials are "well aware of the problem" and two additional medical schools are forthcoming, Fernandez, who has more than 30 years of experience in health care, wonders if that will be enough to deter physicians from relocating.

"Young physicians coming out of medical school and completing their residencies are already burdened, financially strapped, with the bills they accrued while getting their education," he said. "Add the challenge of liability insurance, a high cost of living, rising real estate costs, the challenge of opening a practice and other factors and you can see why the number leaving is increasing. Physicians are no different than anyone else who is young and beginning a career. They want to have a home, get married and start families. The present environment is not conducive for those dreams."

On the matter of "inadequate" reimbursements, Fernandez said the situation is compounded by the fact that many Medicare patients have converted to managed care programs to cover their health care costs. And there is no quick fix in sight, because Florida has more Medicare patients than anywhere else in the United States.

On the flip side of the coin, Miramar benefits from the demographics of its community and its biggest service line being obstetrics and gynecology.

"Weíre very fortunate in that respect," Fernandez said. "The majority of our residents are young professionals of child bearing age, people who are having children and raising young families."

By the end of the year, the two-year-old 128-bed hospital plans to enhance the OB/GYN factor with the addition of a 10-bed neonatal intensive care unit, which will be the only one in Broward County with all private rooms. Fernandez said he also would like to add even more womenís services at the hospital, such as plastic surgery and breast surgery.

Those positive factors notwithstanding, Fernandez is looking for solutions to the myriad stumbling blocks standing in the way of hospitals, health systems, physicians and others in the medical profession.

"There has to be a resolution to these problems," he said. "With the (presidential) elections on the horizon, health care reform is certain to be a major issue. The war in Iraq is grabbing most of the attention, but you can bet health care is going to be near the top of the list of any and all candidatesí platforms."

In that sense health care reform is a national issue, but it is very much a local issue too, Fernandez said.

"It really falls on all of us to address the problems at the grassroots level," he said. "There is too much at stake, not only for our survival as providers but, more important, for the people and the communities we serve."

Community is a major factor in Memorial Health Systemís existence, especially when it comes to giving back to the people. That point was emphasized in May when the health system received the prestigious 2006 Foster G. McGaw Award for Excellence in Community Service. Each year, this $100,000 award is presented by the American Hospital Association to a health care organization that provides innovative programs that significantly improve the health and well-being of the community. Memorial Health System is the first in Florida to even receive the honor. MHS also was the first recipient of the AHAís Living The Vision award in 1997.

Susan Manilow, chair of the Foster G. McGaw Prize Committee, said Memorial Health System was honored for "innovative leadership and partnership, sustained commitment and wide-ranging initiatives that achieve striking results in the health and vitality" of its community.í

"In line with its philosophy that public health and quality of life are inseparable, Memorial Health System has built strong partnerships with other community organizations and community leaders to create a wide spectrum of impressive and effective community initiatives," Manilow said. "From providing programs that significantly help delinquent and at-risk youth, to the homeless, the seniors, the chronically ill and many, many more, Memorial consistently demonstrates how deeply and compassionately they care about all the people of their community."

Those accolades, Fernandez emphasized, signify a basic tenet of the health systemís mission to provide quality health care to everyone regardless of their ability to pay.

"By (federal) law, we cannot turn away anyone who comes to our hospital for care," he said. "But our commitment goes beyond those mandates. We take preventive medicine into the community with wellness screenings, educational programs and even a program in which people can purchase medications."

Patient safety and satisfaction also is a prime item at Miramar.

"We are well aware of the national standards and are pleased that system-wide we are in the top one or two percentile," Fernandez said. "But while we watch the national standards closely, we also share information within our own health system. This affords us the opportunity to compare statistics with our own facilities and set our benchmark. We monitor and review the numbers and look at potential events and how we can avoid them.

"We feel we are better than (the national) average," he continued. "But no mater what your numbers are, you must continue to strive to meet your goals of improving patient safety by reducing nosocomial infections (those acquired during hospitalization) and other errors. Keep in mind, too, that defining quality and satisfaction will be extremely difficult, perhaps impossible, because of the transparency factor. Information about hospitals and physicians is becoming increasingly available to the public on Web sites and in the media. We must continue policing ourselves and tell the story of what we mean to our community."

Fernandez, who earned a Bachelorís degree in business administration and a Masterís degree in health services administration from Florida International University, said he got into health care administration "by accident."

"Iím a Certified Public Accountant and I worked in finance the first seven years of my career," he said. "I decided to try the operations side of the business and I found I really liked it."

Fernandez feels his strong financial background has been a plus in his roles as a chief operating officer and CEO.

"Working in the financial setting requires you to have an in-depth operational understanding of each department and having a solid business background is critical to achieving your mission," he said. "You understand operations by asking a lot of questions when developing departmental budgets and perhaps running various departments or subsidiaries. Broadening your operational experience beyond finance is the key to success Ė for the individual and his or her business."

For more information about Miramar and the Memorial Healthcare System, contact Kerting Baldwin, Director of Media Relations, Memorial Healthcare System, at (954) 985-3455 or, or visit
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