The Maldistribution of Healthcare in America

Two posts from my Google Reader today illustrate the problem we have in distribution of healthcare here in America –

Paul Levy writes how partners Healthcare is building an ambulatory center within 8 miles of the much smaller Norwood Hospital, duplicating services almost exactly and presenting unnecessary competition for patient business.

…the new center is 75,000 square feet and will offer the following specialties: Primary Care, General Surgery, Plastic Surgery, Orthopaedic Surgery, Cardiology, Cardiac Diagnostics, Dermatology, Diagnostic Imaging, Women’s Health, Rheumatology, Rehabilitation Services including Cardiac Rehab, Physiatry and Pain Management.

I now understood why my colleagues at little Norwood Hospital were nervous. Their website says they offer the following services, among others: Surgery, Obstetrics, Cardiology, Dermatology, Radiology, Neurology, Orthopaedics, Gastroenterology, Cancer Care, and Pediatrics. Not a complete overlap, but quite a bit.

Edwin Leap, MD writes about the limitations of practicing emergency medicine in the rural south without the services and expertise he had when he worked in a big city hospital –

…we were seeing some 25,000 patients per year in a 10 bed ED, in a 120 bed hospital. We had one cardiologist, but no cath lab. We had no neurologist, pulmonologist, neurosurgeon, toxicologist, trauma team or pediatric subspecialties….We don’t have residents to help with the volume and we don’t have a trauma team. There is, now, a helicopter service taking our patients to the regional trauma referral center, but when they can’t come, it’s 40 minutes away by ground.

Looks like the Big City has more hospitals than they need. And rural America doesn’t have enough.

Ironically, we have similar maldistribution of retail services in America.

I have dozens of stores within a few miles of my home here in NYC, where Bloomies, Nordstrums, Target, Gap, Old Navy, Sears, Saks and Macy’s all compete for my busness. But I have to drive 40 minutes to the mall from my country house in the Endless Mountains of Pennsylvania, where my choices are limited to Walmart and Sears.

The difference, of course, is that retail emergencies are rare, and never life-threatening. Wish I could say the same for healthcare emergencies.

Kudos to Dr Leap for all he does, and good luck there at Norwood Hospital.

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