Community Hospitals: A Threatened, Valued Resource

The fishhook hung from the lower eyelid like a coat hanger. My son, Angus, was being brave beyond his 10 years, but the sight was horrible, with the squid bait draped down his right cheek. I could not see if the barb penetrated the globe, but in waning light at the tip of Menemsha jetty, I was not equipped to find out. Fortunately, Martha's Vineyard Hospital was a short ambulance ride away and ready for us when we arrived. We were promptly brought into the treatment room, and the hook was skillfully removed by the emergency department physician. Before we knew it, we were on our way home, with the Martha's Vineyard Hospital already an indelible memory.

It was everything one could hope for in a community hospital: friendly, competent, expedient, convenient and user-friendly. The experience was an important reminder of what treasures we have in our community hospitals. These hospitals, the products of generations of public stewardship and generosity, are the indispensable foundation of our health care system. They embody the familiar dictum: the right care at the right time in the right setting -- and they do it with compassion and competence.

Unfortunately, the existence of these hospitals is threatened as never before. They labor under inadequate reimbursement, the rising costs of delivering care, burdensome overhead expenses, a severe shortage of nurses and physicians, and a growing number of patients who are neither insured nor in the free care pool. Many of these hospitals are chronically on the brink of financial failure through no fault of their own, but they continue to deliver the best care possible.

The Medical Society, concerned about the threat to our network of hospitals, has formed a Task Force on Hospital Closure. Chaired by Thomas Sullivan, M.D., this group is examining the forces threatening the economic viability of hospitals and formulating policy recommendations for the Commonwealth of Massachusetts to ensure that these hospitals continue carrying out their vital mission.

The Task Force is working to determine the best way to perform a comprehensive analysis of current and projected hospital needs. In addition, they are focused on safeguarding continuity of patient care, preserving the physician-patient relationship and removing restrictive covenants and financial barriers that prevent moving physicians and their patients to surrounding hospitals when there is a threatened or actual hospital closure.

The Task Force will meet with health care leaders in the weeks ahead to strategize on how best to implement its recommendations. All sectors of the health care industry must work together to strengthen our community hospitals, and the MMS will continue to serve as the leader of this critical process in the coming year.

- Charles A. Welch, M.D.