Tuesday, June 30, 2015

A Local Physician's Perspective

Ann CordumKeep Boise Connected, Inc.

St. Luke’s provides excellent care and top-notch expertise. Hospital executives argue that expansion is necessary because in emergencies, seconds matter. Closure of Jefferson Street would connect emergency services to interventional radiology and save lives.
What save lives are the following: adequate staffing on the front lines of patient care, clinician competence, well-designed processes, and effective communication across the care team. Physical space does not save lives. The larger an organization, the more logistical challenges, and the greater the delays in care. Physical grandeur and proximity do not equal better care. In fact, studies show that patients who have a stroke while in the hospital suffer long delays in getting thrombolysis and life-saving care. Larger facilities are also typically associated with greater overhead which translates into higher costs that are ultimately passed on to us all. Outpatient care costs are substantially higher at a hospital than at a physician’s office.
Only a tiny minority of emergency room patients need interventional radiology. Most hospital admissions are for infections, congestive heart failure, drug overdoses, emphysema, blood clots, surgical issues, and the like. What good is it to whisk someone away for intervention while Mrs. Jones lies on a gurney for hours awaiting admission for her pneumonia? The reality is that cardiac and stroke patients are outnumbered by general medical/surgical patients who often sit in emergency rooms for hours awaiting admission and higher level care. Their lives are every bit as important as the stroke patient’s.
I would ask our community: Has access to your physician improved as a result of expansion, i.e. by hospital acquisition of local physician groups? Did the quality of your health care improve? Has it become more cost effective? Would you prefer to navigate a larger hospital campus?
St. Luke's has a large enough footprint to reconfigure on its existing acreages without closing tax payer owned roads and encroaching on historic properties to expand intersections and roadways. Options include building upward from the existing hospital parking lot or relocating outpatient services to its other Boise properties. This would leave plenty of room at the existing downtown campus for inpatient services and future growth.
For community health, it benefits all to have a safe route of access to downtown, whether on bike, foot, or car. Jefferson Street is the safest route for a child, commuter or family to access downtown.
The solution to growth is reconfiguration, avoiding duplication of services (leave the trauma care to St. Al's), adequate staffing, and reduction of costly executive and managerial positions.
In conclusion, while I am thankful to have St. Luke’s in my neighborhood, there are better ways to spend $400 million improving heath care in Boise than the proposed campus expansion.
Ann Cordum
East End resident
Internal medicine physician

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