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The Values of Hospitals

Over the Labor Day weekend, The New York Times published a column critical of hospital spending. It called, ahead of the Democratic Primary debates, for elected officials and candidates to “address the elephant in the room and tell us how they plan to rein in hospital excesses.”

The data the author uses to form her call to action were carefully selected to support her position, and as is too often the case, fail to account for the myriad cost drivers beyond the control of hospital leaders, such as the high price of labor.

The American Hospital Association has already submitted a response to The New York Times, and has debunked some of the incorrect points in its blog.

We can argue data validity all day, and that work has its place. What’s more important, however, than simply correcting the record for this column – and hundreds of others like it in the past year – is that we take heed of a growing shift in how real people experience their hospital. Despite its many problems, the NYT column sadly does capture the sentiment of millions of Americans.

In June, NPR published “When Hospitals Sue for Unpaid Bills, It Can Be ‘Ruinous’ for Patients.” The piece offered multiple tales of the impact on patients and their families of garnished wages resulting from medical debt lawsuits.

Their stories are heartbreaking.

In the NPR story, the reporter interviewed Martin Makary, a surgeon and researcher at Johns Hopkins Medicine.

“Hospitals were built — mostly by churches — to be a safe haven for people regardless of one’s race, creed or ability to pay,” Markey said. “…They’re supposed to be community institutions.”

Markey is partially right when he says hospitals are supposed to be community institutions. There’s nothing “supposed” about it. You are community institutions.

You are there, 24/7, through all manner of emergencies, disasters, and more. You are economic pillars in your cities and counties. You wake up each day thinking about how to serve people better.

Even the NYT piece concedes: “…when their operations generate huge surpluses…they plow the money back into the system…build another cancer clinic…buy the newest scanner (whether it’s needed or not).”

It’s that last sentence that is troubling. Are we really at the point where we should think that building a cancer clinic or buying a scanner is a bad thing? These are investments that save and change lives. They are made solely with that purpose in mind.

It’s saddening that for some, the impact of not doing these things isn’t considered.

Which brings us back to the experience people have with their hospital and how they feel about that experience. There’s a joke about the airline industry here that is relevant. It goes something like this:

“There you are, 30,000 feet in the air, flying in an aluminum cylinder across the country to see your loved ones in just a few short hours, and all you do is complain that the movie selection is weak and the peanut bag is small. Where’s the appreciation for the miracle of flight itself?”

In 2019, this is our call to action as hospital leaders: to not only perform the daily medical miracles, but also to meet people where they are – so their hospital experience is one that matches your values of service, healing, and hope.

— Carmela