Speaker 0 00:00:00 There are a lot of mental health experts out there. That'll give you their list of tips that they think will help. The problem is they're based on their perception of what is right and wrong University elite, we do something different. We treat our patients using sound psychological, neurological, and physiological science. We know what works and what doesn't. We don't get confused with what's right versus wrong. While others continue to struggle with these tips that they've received, we help people gain the long-term happiness and wellbeing with our approach.
Speaker 2 00:00:33 Welcome to the university elite podcast, where you learn the why behind human behavior and how to live a truly happy life. Now, your host is a combat proven veteran physician, master psychotherapist, diet, expert, trauma authority, and someone who has everyday common sense. Dr. Hans Watson.
Speaker 0 00:01:01 Hi guys. Welcome back to another. Ask the doc segment where we take your questions and apply them to real life and see what's going on for you. We have an interesting one here. We have a question about hospital occupancy rates. And so, uh, this one comes from an individual who has called themselves Jana. So Jana asks Dr. Watson with the COVID-19 pandemic. There have been a lot of questions regarding how full hospitals are and whether that represents an actual emergency that are, we are being overrun with COVID-19 infections. Can you please talk to me about what a normal hospital occupancy rate is in the United States? So that's a great question. Uh, as we said before, I'm not here to argue one way or the other on, uh, the politics of the COVID-19 pandemic that's for somebody else to take on. Um, but instead, uh, we'll just answer your questions.
Speaker 0 00:01:56 Um, it's clear that many people are getting to the point where they're wondering about who to trust anymore. And so, uh, what I'm going to do is down there in the description of this, you're going to have a couple of links of where, where information comes from that you can look at, but here's how it works. You have to look at our hospital this way. You can't build a hospital and have a giant building that just has open rooms and nurses just waiting to occupy them, or they wouldn't be profitable enough to stay open. You have to have a certain amount of your, of your beds filled just to be able to pay the utilities that heat the electricity, the nurses that are going to be ready to work when, when a patient does come. So you have to have a minimum number just to break even, and nobody out there can stay in business if you're just breaking, even because there will be times where you're not making enough times of what we call low census census simply means how many of the beds that you have available are full if you have.
Speaker 0 00:03:00 And so that that's, if you have 50% of it, is that enough to break even generally the answer's no, that it costs to maintain the buildings, keep your weight, your staff there, uh, to have a kitchen, to have all these different things. It costs a bunch of money. And so you figure the number that most people talk about is you don't even break even until at least 65% full. So a wise person would not build a new hospital in an area where they can't even, they can't even maintain the other hospitals at a 65% full ratio. And so when we look at this, some people are wanting to say, and clearly people on both sides of the political spectrum have used these numbers too widely and, and, and crazily, um, manipulate emotions. Don't let them, here's what the facts are. Most of the time, the estimates are you got to have about 65% of your beds full just to break.
Speaker 0 00:04:01 Even you need to be somewhere closer to 70% to have enough profit so that you can have some money in the bank for the months where people are really healthy and they don't need you. And you drop below that 50, but 65%. That way you can weather that storm and stay in business without going into debt. Um, and so the ideal where you're making enough money, that you can afford to do the nice things and continue to upgrade your building. And, and, you know, you can buy a new x-ray machine or a new CT machine, or heaven forbid even an MRI. You know, when it comes up, there's all these things. The ideal place to be would be somewhere right around 80 to 85% full all the time. And this includes your ICU. Now, the problem is, as you go above that, 85, maybe 90% full, this causes other problems because one of the ways that you're able to get in and out, I'm sorry, I'm skipping a step.
Speaker 0 00:05:00 One of the ways that hospitals work efficiently is most other patients come in through two ways. Number one, they have doctors who could admit a patient directly. They have admitting privileges saying this person's sick enough. They need to be in the hospital. I don't need anybody else's approval. The hospital has said, I am good enough to be able to make that decision. And when I do, they have a bed waiting for me to where I can say this patient goes in there, and one of your nurses will start caring for them. And generally that doctor either has an agreement where they'll come in and give the orders of what to do with this patient. Or they'll have a partner in there called a hospitalist who takes over and says, okay, Dr. Watson, you have admitting privileges. I will now see your patient while they're in here and take care of what the thing that you've identified needs, uh, taken care of.
Speaker 0 00:05:49 And so that's the first way is direct admissions by doctors who, who the hospital have identified as we trust you enough, that if you say they need to be here, we know that there's validity to that. You can admit directly to us. Um, most doctors don't do that. Um, then the second one is the ER, your emergency room or it's urgent care room. This is a place where once again, people come in, they're evaluated and those that are sick enough to need to be in the hospital. They're admitted by the emergency room or urgent care staff. Those that aren't, they're treated right there and sent home. Well, the problem is, if you get above that 90% max of, of where you are, it makes it, so there are very few beds in the ER. So instead when, when two people come in and you say, man, these two people both should be admitted into the hospital for care.
Speaker 0 00:06:42 They're they're sick enough. This could go, this could go south. This could be bad really quickly. But when you get above that 90%, there are very few beds left. So now the question becomes, which one of these two do I give the bed to? Because we have so few beds we have to start choosing. We call that word triage in medicine. So you have to start triaging, which one actually goes, which one do I send home? And tell them, I hope the best for you, but I just don't have the beds to admit both of you and this person needs it more than you. Sometimes that's going to be, this person is so sick. There's little chance that they're going to be improved. And so they'll send them home on things like hospice care, other times, it's this person's going to be okay, it'll be rough, but there'll be okay at home.
Speaker 0 00:07:31 And so they'll send them home and give them home health care because they'll be able to heal okay, there, and then they'll admit the other person, but that's the kind of decision. So as we're looking at this and you see the numbers know that most ICU use most, uh, most, uh, hospitals themselves between 80 to 85% is ideal where you'd want to be with how full your hospital is. That means your hospital's full enough, that it's profitable, where you can keep the doors open and continue to have the best, the best doctors that you can afford to pay to be there. The best nurses you have the best equipment, but also you're not so overwhelmed that now you're plugging up the ER and they're having to triage who is, and isn't appropriate. But instead, anybody they feel like is appropriate there's room in there to get them in.
Speaker 0 00:08:19 And, uh, and so then that's the number you want to look at. So as you're watching the news somewhere between 80 and 85 is what we ideally would maintain all the time in each of our hospitals. And so, um, that hopefully takes away some of the emotionality of it, a door people can manipulate you and say, aha, look, see, I'm going to use this number and not tell you what normally is in order to do that. You know, hospital that drops below that 70%. They're in danger of closing the doors through bankruptcy. And so never want to drop below 70 is what most of the, uh, the bean counters have told us. And you really never want to go above is what the other bean counters have told us. So if you're outside those numbers, now you should have the real numbers and the facts and not let people manipulate you one way or the other. So keep those questions coming, glad to have them. Uh, if you want to, you can always ask a question on, ask the doc section of my [email protected]
. Once again, that's university elite.com and ask the doc and shoot me a question. And we, we pick a question and answer the ones that, uh, that, um, we think we have some insight on. So hope that helps you guys have a great day and be well