Hospitals aren’t what they used to be

Once upon a time, most American kids, if asked the name of the place where people work, would confidently answer ‘office’ or ‘factory’. And what do we call the place where we go when we need medical care? The hospital. These days all sorts of work is being done in coffee shops and at kitchen tables. And when we talk about health—which we seem to do a great deal—we are more and more likely to talk about diet or sleep, exercise and stress, or many other topics well outside of hospitals or what goes on in them.

In fact, even when we talk about hospitals we may not be thinking about large buildings with operating rooms and clinics, emergency rooms and blood donation centers, maternity wards and chemotherapy and dialysis facilities, wards where old folks breath their last while elsewhere a kid who fell off his bike gets her scraped elbow stitched up and so on.

When many hospitals operate with mounting deficits the decades old discussion about a system more focused on disease management than health care suddenly gets more pointed. We seemed to be able to live for years knowing our health care system leads the world in expense but lags in results. A local hospital closing brings things home: our health care system is, in a word, unsustainable.

There are perfectly good reasons to think about how hospitals can be re-imagined and re-designed—to speak in terms of health villages and consider the advantages of neighborhood clinics for non-critical care, of home-based recovery and ways of offering services from check-ups to end of life care.

No one cheers the failure of a hospital, and when a closing leaves a community without access to services, it can be dangerous as well. But money talks, as usual, and if it speaks to the need to re-define health in ways we can’t ignore, that’s not all bad. It is high time we focused on health in our every day lives, on prevention and wellness, on what we eat and how we live, on all the aspects of our daily lives that we control.

The need for the medical interventions that hospitals are well suited for is not going away anytime soon. But its high time we created systems of care that are focused on helping us all live as well as possible.

by Danny Abelson