Doctors and Diagnosis—Short an Operating Room

By Siggy Raible
What follows is one reader’s very accurate portrait of a typical emergency situation.
What seems to be left out in talking about the logistics of getting a patient from 13th Street to Lenox Hill is the pain and anxiety of the patient. I know because I had an identical experience. I had a bowel blockage and I was continuously vomiting. They put me in an ambulance and in heavy traffic on pothole replete streets made the nightmare journey to Lenox Hill.
It seems to me that good medicine starts by getting as close to the patient as possible by having a neighborhood hospital—and then the patient should be as close to actual treatment as possible, i.e. the operating room, from the diagnosis.
Hospitals are not obsolete. (And she even complains about the cab fare going home—this is the real feeling about not having a local hospital after having one for more than a century!)
—George Capsis
I write to you concerning Joy Pape’s article entitled “Northwell Returns Doctors to St. Vincent Site.” Ms. Pape, as a board certified family nurse practitioner, reports that Northwell just opened a walk-in medical suite of offices offering specialists in the major medical disciplines. The only problem is that if you happen to have a true medical emergency requiring surgery, like an appendectomy, those specialists will not be able to treat your emergency at LIJ’s Greenwich Village Emergency Department because it is not equipped to treat that specific emergency. So why is it called an Emergency Department?! I honestly don’t know. (And good luck with trying to get into a hospital where your doctors are affiliated.)
What happens is if you are like my friend (she’s the one who needed an emergency appendectomy) and you’re unable to secure a bed in the hospital where your doctors are affiliated and you are in so much pain that you want the whole thing to be over with, you agree to be treated at LIJ’s real hospital located at 77th Street and Lexington Avenue. We spent a total of 10/11 hours, she in agonizing pain—we waited to be examined at Lenox’s Emergency Department at Seventh Avenue and 13th Street, we spent an hour in an ambulance travelling in traffic lurching from side to side over potholes up to 77th Street. When we finally arrived, we waited some more to be re-admitted into Lenox Hill’s real hospital and eventually “intra-hospital transport” to the operating room. (By the way the surgeon never met with us before the surgery.)
Ms. Pape, who in an interview with Dr. Warren B. Licht, M.D., the Vice President of Ambulatory Operations for the Western Region and the Director of Medical Affairs for Greenwich Village Lenox Health (a mouthful), reports that he feels this method of delivering emergency care is just fine since “sometimes it may take longer to get to an operating room from an emergency department that is located in the same building due to many factors including intra-hospital transport.” WOW. If this is true, how sad is that!
Okay, so surgery was successful, but I had to return to Greenwich Village. After a long day at the emergency department and the hospital I was not about to take the trains at 11:00 p.m., besides which the Lexington Avenue 77th Street Station was closed for repairs. So I hailed a cab and it cost me $30 to get home. (If there was a hospital in the Village, I could have walked home.)
Maybe Ms. Pape or Dr. Licht can explain to us Village, Chelsea, Soho, and Tribeca people why this arrangement for the delivery of hospital care works better for us than having a full-service hospital in the neighborhood. This question needs to be addressed now, since Mt. Sinai’s Beth Israel 800-bed facility located at 17th Street and First Avenue is downsizing to something like 250 beds. Keep in mind that when Beth Israel downsizes, the only other full service hospital below 14th Street is located on Gold Street in the Financial District. It has 180 beds. Where will the residents south of 14th Street in Manhattan go for hospital care? The nearest hospital on the west side is located at 59th Street and Tenth Avenue; on the East Side, residents can look to Bellevue Hospital. Talk about competition for hospital resources!
Thanks for listening.

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