Hospitals: Small is beautiful


Hospitals: Small is beautiful

A distinguished hospital district?

If the hospital district does not go through with the project, then people shall die!

Such conditioned hypotheses are always true. And, the concept Life Is Priceless is a big reason — but far from the only reason — health care costs have increased from 3.5 percent of the economy in the 1950s to almost 20 percent today.

The ideal Grays Harbor Community Hospital does not resemble the current configuration.

Doctors do not deserve convenience. They blew it a half century ago when they did not want to work with the government. When the Social Security Amendments passed as part of the Great Society, doctors were promised normal and customary fees. The nearly immediate chaos demanded outstripped supply. The docs did not want to fix, and they walked. Fortunately, the antediluvian mindset has improved, though not profoundly.

Productivity is the name of the game. So often, surgeries fail more often at institutions where the physicians perform fewer of the medical procedure. If Olympia has a lower error rate, why think about GHCH?

Who might think about the hospital district is the UW medical school. Our nation’s first or second clinical medical college (according to U.S. News over the past few years) could advise impartially here (as compared to, say, Tacoma).

Costs are hugely lower when our hospital does not feel the urge to Keep Up With the Joneses. And, nearly all do have the urge. Legislation was passed in many jurisdictions for government to oversee large capital outlays. No real successes, so far as I know. The commissioners, doctors and management must understand and practice Small Is Beautiful.

What is also beautiful is very fast transit to tertiary care. That means helicopters and not only one. My justification is twofold and far afield.

Filling stations have two bathrooms, these days not so much for gender separation, as for their aversion to irate customers.

The first computerized typesetting operation occurred in the teletype room of the Time-Life Building in New York. In the days when Time, Inc. ordered two computers, a computer twice as expensive computed four times as fast. But the production chief believed deadlines would fall without a spare computer.

The hospital district has an opportunity to improve care somewhat and cut costs. A small institution is justified only when those individuals past unsupervised care see fewer errors and recover more quickly. But substantial size reduction only justifies itself when the larger environment takes part in the process.

Robert Rooe Simpson

Ocean Shores

 

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