In my local paper, the Providence Journal, was this story about the now annual winter event, the hospital capacity crunch. With even a small and routine uptick in influenza and respiratory illnesses, local hospital emergency departments overflow, and patients wind up in every corner. Everyone seems bewildered by this, although the article notes that the new leaner hospitals run an 90% capacity, so any increase in demand overwhelms them. Furthermore, it seems impossible for hospitals to get enough nurses, although no one seems to care to think about why.
Similarly, in Houston, a story from the Chronicle about how the new Texas law designed to make mental health care more efficient has resulted in long waiting lists for anyone not overtly psychotic, and an apparent dearth of chronic care.
At the same time, the Chronicle reported how the latest trend in Houston general hospitals is patient amenities. It described, for example, the University of Texas M.D. Anderson's new Ambulatory Clinical Building, "with its commissioned artwork, hotel-like lobby, waiting rooms with wireless internet access and garden terraces."
So we have poverty amidst plenty. In the US, where health care costs increase annually much more than the inflation rate, where we spend more than $1.5 trillion on health care, we cannot provide enough emergency room and hospital capacity for the predictable acute respiratory illness surge in winter. In one city, the wait for an out-patient mental health care appointment for the poor is 3 1/2 months, but a state-supported hospital now displays commissioned artwork and provides wireless internet access? What does this say about the values of our health care leaders?
An inadvertent physical exam - “Nobody does this …” Dr. D said as a greeting as he walked in holding the 700-word letter I had sent him some weeks before my periodic physical examination...
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