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When You Close a Hospital You Kill a Medical Community

By George Capsis

“The recent article in WestView News about the closing of Beth Israel really needed the entire paper, cover-to-cover, to uncover what’s really happening.”

Wow, we don’t get many letters with an opening like this—ever.

The letter was written by a 62-year-old West Villager with chronic blocked arteries whose surgery had been done at Beth Israel by a “world-renowned surgeon who has done 10,000 such operations.” But—and here is the reason why this letter is so important—“this surgeon was one of the first staff members to flee Mt. Sinai after the takeover less than two years ago.”

Yes, Beth Israel even then was moving towards bankruptcy—just as 20 New York hospitals have done in the last 16 years. Mount Sinai’s Board of Directors, since they were, at the time, still solvent and hence they must be doing things right, made the decision that they could save Beth Israel. They were wrong—very wrong.

Angry Beth Israel nurses leaked a story to the Villager’s Lincoln Anderson that the hospital was to be closed. Panicked Beth Israel management used the same PR agency—SKDKnickerbocker, which Bill Rudin used to pacify a distraught West Village when they nailed plywood over the emergency door of St. Vincent’s—to say, “No, we are not closing Beth Israel, but rather investing $500 million in revamped medical services that would better serve those of us who are now using Beth Israel as the nearest emergency room.”

I think we have to thank SKDKnickerbocker for a neat bit of doublethink. To paraphrase, “We’re not closing Beth Israel to end an $80 million-a-year drain, but selling it for $500 million to bring you a better-focused and stripped-down medical service that will keep you out of hospitals, seething as they are with infections.” They even talk about home hospital care and ambulatory surgery—you get up from the operating table and take a cab home.

As I write this article, NYC Health + Hospitals, which operates City-owned hospitals like its flagship Bellevue, announced the steepest budget shortfall in history—it has a budget of $7 billion and 82% of its patients have no insurance. The City is expected to come up with $2 billion (but by law, anybody who walks into an emergency room must be treated, regardless of ability to pay).

When Arthur Schwartz and I interviewed Bill de Blasio during his mayoral run—at the time he was 80 points behind Christine Quinn—I got up and threw my arm around the seated 6’5” candidate in an impassioned moment and said, “You’re as old as my son and I am telling you that you have got to save the hospitals if you want to be Mayor!” Later, he got arrested and handcuffed to save his local Brooklyn College Hospital, which, prophetically, is now becoming luxury condos.

But back to the author of our letter. He talks about a 2008 surgery during which his heart was stopped for 73 minutes, and of the staff of Beth Israel, “Every single person I encountered was the utmost professional, courteous, and accessible.” Here, he is talking about the professional medical community that evolves over years and even decades in every hospital; they form an extended team as connected and disciplined as the fingers of a surgeon.

When St. Vincent’s went under, I took my wife to a new doctor who had been with the hospital, and he described the virtues of a medical community. “When I was unsure of a diagnosis, I would kick it around with a few of my trusted doctor pals over lunch in the cafeteria to come up with an answer.” I mean, this is the definition of a “medical community.”

For those who make a salary running the “business” of hospitals, the hottest idea going is offering reduced medical services from a storefront location “doc-in-a-box.” And that is part of the Mt. Sinai plan—to sprinkle “doc-in-a-box” locations from 23rd Street down to the West Village, with nice, young, fresh, and inexpensive doctors right out of medical school.

Oh, yes! They will, in four years, offer us a 70-bed hospital on 14th Street and 2nd Avenue. But wait! If you’re not ready to believe, you can go from over 800 current beds to the 70, which the hospital rendering offers—a dotted line above the roof—to say that we can always build a scaffold around the new 70-bed hospital with sick patients, bring in a construction crew with jack hammers, and in 24 months of heavy construction, give you 70 more beds.

Our writer ends with, “I hope my cardiologist doesn’t decide to move to Florida or Pennsylvania where, I’ve heard, they take better care of their elderly and sick—and their healthcare professionals, too.”

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