Published by: Larry Gage on 4/12/2010 12:25:25 PM
The tale of my 24 hours at St. Vincent is a long and sorry one—and likely to be of interest largely (if not entirely) to my mother. So I will spare you the details (how quaint in the twitter era, I hear you saying). Suffice to say that—perhaps due to the fog of pain and Percocet—it took me a bit longer than it would probably have taken you to realize that YOU REALLY DON'T WANT TO HAVE SURGERY IN A CLOSING HOSPITAL!!
The first sensible advice along these lines came from a close family friend who just finished her emergency physician residency at Bellevue. I will let her words of wisdom, speak for herself:
"I would be a little concerned about the hospital. You don’t really want to be the first patient or the last patient in any hospital, as a rule of thumb. I just checked St. Vincent’s Hospital Compare percentages for major joint surgery (pre-op antibiotics, etc.) They weren’t fantastic to begin with (certainly worse than Bellevue or HSS) and I’m guessing their staffing and supply chain are in-flux right now, which probably doesn’t help. (I heard vendors weren’t delivering unless they got paid in cash.) You don’t want them to run out of things in the middle of your case, or have your OR staffed by the one scrub nurse who hasn’t managed to find a job somewhere else…"
The reality of this warning became clear as the day –then the evening—wore on. Nurses were in short supply—they were said to be "using up their sick leave before the bankruptcy filing.” Supplies were also in short supply. I was given a less than optimum leg brace because (according to the resident) "we normally special order the high tech ones but all the suppliers have cut us off.” The staff were clearly distracted—the clerk on the admit desk spelled my name "Bage" on my wrist tag.
The staff who did show up for work were extremely cordial and helpful, but clearly overwhelmed by their circumstances. Ultimately even the surgeon agreed that I should have this surgery elsewhere—and placed a call to a former colleague (his teacher, actually) at the Hospital for Special Surgery on the upper east side. They can't see me until Monday—but at least I'll spend the weekend in the comfort of my own apartment, not a dying hospital.
There are lots of theories about the closure of St. Vincent, but the interesting thing is, the New York state government did not predict or order it, and much of the city is clearly in mourning. (See New York Times articles: With the Closing of a Hospital, Women’s Childbirth Options Diminish and As St. Vincent’s Closes, Other Hospitals Get Busier)
New York has long been infamous as a nanny-state, protecting its citizens while dictating how many different industries operate to a much greater degree than other states. While some higher level of consumer protection no doubt results, there is also a much greater nuisance factor for industry—and especially for hospitals and other health care providers. Case in point—several years ago the state appointed a commission (called the Berger Commission, after its chairman) to study the hospital industry and recommend changes (including mergers, changes in size or programs, even closure). The Berger Commission's recommendations were backed up by threats of adverse reimbursement or regulatory actions on the part of the state, and many of its recommendations have subsequently been implemented.
But the closure of St. Vincent-Manhattan (as this hospital is known) was not among them. In fact, the Commission recommended the closure or conversion of several other lower Manhattan hospitals or programs, on the theory that St. Vincent would pick up the load. Most of those other closures have now occurred.
So goodbye St. Vincent! I'm sure we haven't heard the end of the story.