March 17, 2008
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The small town hospital
ASK DR. BOB As you probably figured, I am a fan of the small town hospital. Please note that I am not a fan of a small-time hospital. They are definitely not the same. The small town hospital is very much improved over the past several decades. No longer can it use left-over, second-rate technology, not in the X-ray department, the laboratory, the emergency room, or the pharmacy. Gaps in quality would be quickly noted by the staff, and almost as quickly by the patients, and would not be tolerated. Worthwhile equipment that works reliably and economically is used de rigueur. Any second-rate equipment is soon discovered and must be replaced. The small town hospital is still a hospital, and must be reviewed regularly by the master of reviews, the Joint Commission on the Accreditation of Healthcare Facilities, TJC. Any hospital (with a few exceptions) that receives Medicare funds must pass muster in order to continue to receive them. You can be absolutely certain that any hospital that passes review possesses the same quality of care as any other hospital. The standards are applied indiscriminately. I have seen these reviews in action for 30 years, and despite partisanship, lobbying, funding, and desire, these reviews are fair and indiscriminate. Large and small, metropolitan and rural, accreditation counts the same. This has leveled the field, and patients can rest assured of this. There
are many and diverse reasons for preferring one hospital over another, but
basic competency is not one of them. There are government-sponsored websites
where hospitals are required to publish statistics relating to treatments
delivered, complications noted, and compliance with care standards reported.
The patients and public have ready and real access to these data. A rational
choice can be made, and for reasons I will explain in later editorials, the
small town hospital is often a better choice. |