Family Physicians in the ED

Re: "Family Physicians in the ED" by Danny Greig, M.D., W. Anthony Gerard, M.D., Kim Bullock, M.D., and Kim Yu, M.D. in H&HN Daily May 10

As a past administrator of two critical access hospitals, I have to agree wholeheartedly with the authors of this article. I found that family practice physicians did a better job for a small town hospital than the ER specialists who seemed to always want trauma, which we had very little of.

— Robert R. Bash, FACHE
CEO and Administrator
Doctors Hospital at Deer Creek

The Hefty Cost of Happy Surgeons

Re: "The Lure of New Devices in the OR" by David Ellis, J. Edson Pontes, Donald Weaver and Charles Shanley, H&HN Daily May 15

A good article. Unfortunately, it will not stop physicians from wanting the next technological marvel and hospitals from purchasing it to keep the doctors happy (i.e., proton beam emitters). For this machine, it is already believed that too many exist and this number is expected to double in the next five years. How happy will hospital administrators be when they cannot make back their initial investment?

— M. Bennet Broner, Ph.D.

Care Meets Culture

Re: "Is Your Hospital Prepared to Care for Latino Patients?" by Marty Stempniak, H&HN Daily May 22

Don't forget the cultural aspects too ... having enough space for extended family who may accompany the patient to an appointment, etc. Providing culturally appropriate care is more than just a language issue.

— JSantiago

The Root of the Problems

Re: "Massively Coordinated Care" by Ian Morrison, H&HN Daily May 1

I am really pleased to see this article and will share it with our network here in Massachusetts. Our government is trying to contain the costs of medical care since we have almost completely solved the access to care problem for many people; attention is turning to other methods of reining in costs.

This is a complex problem and as you observed, other partners, some never thought of, need to be a part of solving … problems, such as lack of safe streets, roads and sidewalks, access to healthy foods and so on. In some communities there needs to be a "retrofitting" of new investments to make bad and unhealthy neighborhoods better. The health care establishment carries a lot of weight to influence change, [which] needs to be used to label unhealthy contributors to our cost overruns! Health care cannot and should not try to do it all!

— Peter Lee

Who's Stalling?

Re: "Transforming Care Delivery" by Paul Grundy, H&HN Daily May 21

It's easy to call for a transformation of the patient's progression of care in a hospital and quite another to make it happen. Unlike the payer environment, hospitals are dealing with dual governance systems and "accommodating cultures" that will resist any interference with medical autonomy. The board of directors and the exec team … will not move off the dime until they feel the financial heat. By then, it'll probably be too late.

— Stefani Daniels

Caring for Health Care Staff

Re: "Mental Health and Hospital Employees: Taking Care of Our Own" by Mary Grayson, H&HN Daily May 16

I'm a psychologist and last week I sat next to a VP of human resources for one of our hospitals here, and she said she's looking into a health and wellness program for employees, which would, hopefully, help address their mental and emotional health needs. I've been teaching these programs to private patients for years and know that health providers are starving for them. How do you suggest health providers like myself help hospitals … ensure that health providers have access to programs like these? Sometimes, it seems hospital administrators resist supporting such initiatives for fear of cost, not knowing where to start, etc. But as you so clearly pointed out, how can they afford not to?

— Diane Sanford, M.D.