Something to think about

October 30, 2010
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“Medicine is art informed by science.” — Marc Roberts, Ph.D., Harvard School of Public Health.

“We are not here to compete, we are here to bring superior patient care.” — Ted Lawrence, M.D., University of Michigan professor, at the UM/Metro Health Cancer dedication.

Dr. Jerome Groopman in his book-length essay titled “How Physicians Think” published in 2008 makes the observation that primary care physicians are not merely gatekeepers, but interact actively with specialists to whom they refer. He goes on to say that health care is not a commodity, but a mix of art and science.

Saint Mary’s and Metro Health Hospital are cooperating in attempting to obtain permission to do cardiac treatment in our communities. We have laid out what we believe economically are the arguments, but more needs to be said.

Both Saint Mary’s and Metro Health Hospital have a long tradition of integrating primary care with specialty care. Our respective primary care organizations, Advantage Health and Metro Health Enterprises, are not merely gatekeepers for referrals, but rather part of the treatment team, in this case for cardiac disease.

This is born of our respective traditions. Saint Mary’s is a Catholic organization with a philosophy of community treatment. Metro Health Hospital approaches health care from the osteopathic tradition, whose founding principles are treatment of the whole person. Specifically, this means in both organizations that not only the presenting problems of a health condition (i.e. cardiac disease) but also the cultural and psychological status of the patient is taken into account in the treatment plan. This means that the inability of our physicians to treat cardiac care through all phases is impaired by our lack of permission to do cardiac treatment (i.e. interventionalist cardiology and open heart surgery).

In the brave new world of “evidence-based medicine,” it is assumed the accurate transfer of information through electronic medical records will create efficiencies in cost savings. Although this assumption is true in part, it misses the larger question. Health care is not a commodity service, and there is great variation in what patients bring to the setting. Those variations are not only clinical, but cultural and social.

We therefore think it’s important that once a patient chooses Saint Mary’s or Metro Health Hospital as a caregiver, the patient should have the freedom of choice to remain with that system through the treatment process, including cardiac treatment. 

We therefore hope you will take these facts into account in making your decision in supporting our certificate of need for open heart surgery and elective angioplasty, which are really the two major interventions for cardiac disease along with medical treatment.

(Ken Nysson is a health care planner who was most recently involved in the bid by Metro Health for a certificate of need for open heart surgery.)

Ken Nysson, MSW

Grand Rapids

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