New Jersey is home to 48 “teaching hospitals” that provide essential education and experience to the next generation of physicians and other clinicians. Their work will become more important than ever as the country faces a looming physician shortage.

The United States is expected to face a shortage of 62,000 physicians by 2015, according to the American Association of Medical Colleges.

By 2020, the shortfall is expected to exceed 91,000. Clearly, the current supply of physicians is not sufficient to meet the demands of an aging population and a changing healthcare system with greater emphasis on primary care. The shortage will only be exacerbated by the 32 million Americans we expect will get health insurance under the Affordable Care Act.

Teaching hospitals are essential to the future of healthcare delivery, not only because they serve as the “classrooms” for physicians, nurses and other healthcare professionals, but because they are centers for the development of emerging medical services through research and clinical trials. Teaching hospitals provide many specialized services including burn units, transplantation programs and trauma centers. And they perform yet another essential social service – safety net healthcare to New Jersey’s uninsured.

I am proud of the contributions of all of our state’s hospitals – large and small, urban and suburban, independent or part of a larger system. Each holds a unique and valuable place in our healthcare delivery system. And so it is with teaching hospitals, who serve the larger healthcare community by preparing the physicians of tomorrow.

Statistics show that about 30 percent of the nation’s physicians will enter retirement age in the next decade. Their replacements are preparing for the future today in our teaching hospitals.

I watched the last episode of House last evening with my husband, who is an avid fan of the show. I used to be a regular viewer too but fell out of the habit. I know there has been a lot of media attention on the last episode, and I thought it appropriate that someone from the New Jersey hospital community should say an official, “Goodbye and thank you, Dr. Gregory House.” Unless you’re a regular viewer, you may not realize that the long-running TV series was set in the fictional “Princeton-Plainsboro Hospital.” Some of what occurred there was definitely far-fetched (it was TV, after all) but there’s no denying that a hospital setting provides plenty of fodder for life-and-death drama. Dr. House, of course, always seemed to create his own drama by terrorizing many an intern, resident, administrator and patient, but he also was always able to diagnose the patient by the end of the hour and be the hero. Thanks, House. Your N.J. hospital family will miss you.

This week is both National Hospital Week and National Nurses Week, which happens to be a “happy coincidence.” As I like to say, nurses put the heart in healthcare, and it’s very often our nurses who are the “face” of hospitals and provide the human connection between New Jersey’s hospitals and the 18 million individuals they serve each year.

It’s fitting that I started the week in Washington, D.C., for the American Hospital Association’s Annual Meeting. Much of the meeting was focused on patient-centered care. Among the speakers was Teri Fontinot, the new chair of AHA and CEO of Woman’s Hospital in Baton Rouge, La., who coined a new mantra: “If it’s right for the patient, then it’s right for the hospital.”

One of the freebies I received at the AHA meeting was a blue bracelet commemorating Hospital Week – blue, like those block H signs along our roadways that signal the path to the nearest hospital. We pass them every day, taking them for granted as they blend into the landscape. But in an emergency, those blue signs stand out like a beacon, leading to one of New Jersey’s 73 acute care hospitals that deliver healthcare services 24 hours a day, seven days a week, 365 days a year to everyone, regardless of their ability to pay. It’s reassuring to know they’re there.

I’m asked very often how I like my job. And I can sincerely say I love it because I get to wear the white hat representing a part of society that takes care of people each and every day. But the true heroes are the hospital professionals who take care of our patients – including our nurses, the original “white hats.” So Happy Hospital Week and Happy Nurses Week – and thanks to both for their perfect synergy in taking care of our patients and our communities.

There’s been a lot of buzz this week about a news segment on the NBC program Rock Center about “permanent patients” – that is, patients who in essence become tenants at acute care hospitals because there’s nowhere for them to go once they’re discharged. These patients can stay for months and sometimes years, even if they no longer need an acute level of healthcare services. And because many of these patients lack health insurance, they can rack up overwhelming costs that the hospitals must absorb.

The news team shared stories from hospitals in New York, Illinois, Florida and Arizona, but I've seen it here in New Jersey as well. Very often these patients are uninsured; sometimes they are undocumented immigrants. They arrive at the hospital for needed care. And when they've recovered enough for discharge – but perhaps still need ongoing care in a nursing home or rehabilitation facility – the hospital may not be able to find a facility to accept the patient. Many post-acute facilities provide charity care and otherwise work with patients who are uninsured or underinsured, and I applaud them. But even with their efforts, there remains a systemic lack of access to care for many of these patients.

Rock Center spoke to Ashish Jham, a professor at the Harvard University School of Public Health, who estimated that there are tens of thousands of these patients stuck in the nation's hospitals with no clear place to go.

I don't share this tale to protest hospitals' role as our society's healthcare safety net. It's an intrinsic part of hospitals' mission and they willingly accept the legal and moral obligation. But it is important to understand this problem and the tremendous burden it places on our hospitals. That safety net role requires adequate recognition and financial support from government and other healthcare stakeholders.

Unfortunately, with the continued uncertainty surrounding health coverage in our nation, this problem – like these permanent patients – could be with us for a long, long time.

Guest Blog by Aline Holmes, RN, director of the NJHA Institute for Quality and Patient Safety.

I’ve been fortunate to have served as a nurse for more than 40 years. I’ve witnessed a long list of medical advances over the years – not the least of which is the lifesaving possibilities of organ transplants. I’ve seen patients with just days to live transformed into vibrant, healthy individuals, thanks to the tremendous gift of organ donation.

There currently are about 110,000 men, women and children across the United States awaiting a lifesaving transplant. 5,000 of them are our neighbors right here in New Jersey. A new name is added to the national waiting list every 12 minutes. And sadly, an average of 18 people die in our country every day, still waiting for a transplant.

Despite New Jersey’s rising national reputation in delivering quality healthcare, the Garden State has fallen behind in organ donation. Our state ranks 41st out of the 50 states, with only 31 percent of eligible residents registered as organ and tissue donors. New Jersey is working hard to reach the national goal of 50 percent registered donors, and I applaud the state’s hospitals and our two organ procurement organizations for their efforts to boost organ donation.

But the biggest heroes in organ donation are the selfless individuals who add their names to the organ donor registry. April is the national observance of Donate Life Month. I urge all of you to register as an organ donor. You can join New Jersey’s list of registered organ donors the next time you renew your driver’s license. Or, better yet, act today through the state’s Motor Vehicle Commission, accessible via the Web site www.donatelifeNJ.org.