Thursday, July 16, 2009

Our Hospital

Ten years ago, our hospital consistently registered 70% capacity. Today, we are hobbling along with 15 %. Our financial reserves are rapidly becoming depleted. Before we demand the resignation of the CEO or blame the medical staff for this predicament however, it would be prudent to determine the reasons how we got to this situation.

The practice of medicine has considerably changed over the last 15 years. New drugs have been developed that are significantly more effective against a wide array of diseases. In the past, patients with bacterial infections would routinely be confined for 2 weeks. Many of those infections can now be treated with more potent oral antibiotics that can be taken at home.

Entire hospital wings were dedicated to “chronic lungers”, those with chronic obstructive pulmonary diseases. With home oxygen, nebulizers, more efficient medications and the steady decrease in tobacco use, hospital admissions of this nature have dropped considerably. Patients requiring intravenous anticoagulation would stay in the hospital for weeks. Now available are anticoagulants that can be injected once daily. Many complications arising from diabetes are being avoided with more frequent monitoring of blood sugar through the extensive availability of glucometers and regular HgBA1C testing.

Patients with chest pain used to be observed in the ICU. This is no longer considered appropriate in the majority of cases due to the wide availability of invasive tests that can promptly diagnose and treat the presence of a blockage. In addition, drugs that control blood pressure and cholesterol are far more effective in preventing coronary events.

Many malignancies are being discovered earlier forestalling prolonged and extensive hospital confinements. In the early 1980’s, gastric ulcers would merit a month-long confinement with a bland diet and often end with an operation that would remove a portion of the stomach. A class of drugs known as proton pump inhibitors have rendered this type of surgery largely as a historical curiosity.

Home health and hospice care are innovations that have largely achieved their stated goal: to reduce hospital admissions. There are new medications that slow the progression of dementia as well as osteoporosis, major morbidities that accounted for numerous admissions from nursing homes.

Preventive medicine in the US through widespread vaccinations, screening examinations, awareness programs that promote healthy lifestyle modifications is an unqualified success.

To characterize this slump as a cyclical phenomenon much as we ascribe droughts is a serious mistake. Those old days and old ways are gone for good. Instead of pining for a return to those times, obstinately adhering to obsolete strategies, our hospital must strive to re-invent itself in order to remain relevant.

As the principal stakeholders of the Memorial Hospital of Texas County, we must all get together and search for solutions that will continue to make our hospital viable. It is to everyone’s interests that we have a well-equipped and well-staffed community hospital that can provide round-the-clock care and expertise to support the dedicated efforts of our local physicians. Our hospital must strive to offer services above and beyond the reach of clinics and work in close and seamless partnership with the various healthcare workers in our area.

Hospital-supported facilities should always serve the needs of the common good; redundant positions discontinued, and a comprehensive, far-reaching business plan developed which will guarantee the stability and growth of our hospital.

There are no challenges too great to a united community, determined to preserve an essential institution.