It seems hard to imagine there’s a more difficult business out there to manage than a health care institution.
It’s one business we all make use of at some point in our lives (the other, I suppose, is the funeral home) and it’s one that matters to each of us a lot.
We want good doctors and a good hospital close by.
Health care has become so segregated these days, it’s virtually impossible to keep up with all the different kinds of facilities, where to go for what and who to see for this.
The family doctor has largely disappeared, replaced by large – often hospital-owned – medical practices with several doctors where you’re as likely to see a physician’s assistant as you are a full-fledged doctor. (Don’t worry, you pay the same price.)
Hospitals are trying to figure out their role in the health care system. Many of them have expanded into medical centers. They not only provide inpatient services (you know, the hospital bed for the sick person) but they are often associated with other services like specialty practices (who knew there were so many foot doctors in the world?), nursing homes and adult daycares.
As insurance grabbed control of your healthcare (that’s another column) medical expertise became secondary to the almighty dollar and hospitals and doctors were forced to push patients out the door faster and faster. Up cropped day surgery units where you could go in one morning and go home that afternoon after some “minor” procedure like, say, cataract surgery.
Then the medical community created rehab centers. Those are places where sick people can go to recover when insurance won’t pay for them to recover in the hospital. Sure, the need may not be as acute, but we’ve seen some pretty helpless people in some of those rehab centers.
In Wake County, the medical care landscape changes on what seems like a daily basis. Long gone are facilities like Eastern Wake Hospital in Zebulon, North Wake Hospital in Wake Forest and South Wake Hospital in Fuquay-Varina. WakeMed and Rex owner UNC Hospitals are in an arms race, each looking for a leg up on the other. Duke has dipped its toe into the Wake County turf war, but at this point, it has avoided the acrimony that exists between WakeMed and UNC Hospitals.
WakeMed announced recently that it was going to close two facilities in the Wake County hinterlands of Zebulon and Fuquay-Varina. At the same time, work is finishing up on the new WakeMed Garner Healthplex. In short, WakeMed is going where the money is.
Garner, with its 26,000 or so residents, represents a larger market than the Zebulon or Fuquay-Varina markets.
Fair enough. In addition to making more money for the hospital, it also stands to reason that more people will be saved if a significant medical facility is closer to them.
For now, the story has a happy ending in Garner, not so much in Zebulon and Fuquay-Varina, where homage to the almighty dollar has won out.
But, don’t fool yourself. As the demographics change, you can be sure there will be more changes. And hospital leaders probably don’t have a much better crystal ball that you or me.