What's Happening To Hospitals?

Healthcare in our country is changing. With change comes uncertainty. And uncertainty creates anxiety. Still, as I observe what’s happening around us, I see a lot of opportunity -- opportunity to transform the way we’ve been providing health care into a system that makes sense for the people of today.

A good place to start is to talk about the role of hospitals. Over the past 25 years, hospital usage has dropped. More than 200,000 hospital beds have been closed in the United States. Not coincidentally, outpatient visits have risen by 200 percent over the same period. It’s not to say people no longer need hospitals; rather, the purpose of these structures is changing. The one-size-fits-all hospital is morphing into an integrated healthcare system combining high-volume specialty centers with widely accessible primary care services.

Empty beds are having a negative financial impact on hospitals that are already struggling to pay for expensive imaging equipment and health information technology. As of 2009, more than half the hospitals in America were losing money. Economic success isn’t the whole story, though. The health of patients is also at stake.

An avalanche of studies have shown that outcomes are better at specialized medical centers with high patient volumes. The reason why: the more you perform a procedure, the better you get at it.

Cleveland Clinic is a model for this type of system. We offer patient care services through integrated practice units we call “institutes.” An institute combines medical and surgical services for related conditions or body systems. Our specialists accumulate enormous experience in their area of focus. In my case, Cleveland Clinic’s high-patient volume allowed me to operate on thousands of patients with heart valve disease.

A hospital that does only a handful of certain procedures every week will not have the same outcomes as a center that does hundreds. Take obstetrics: Would you rather have your baby at a hospital that delivers a dozen or so babies a month, or one that delivers half a dozen a day? Which hospital is going to have the most practiced and experienced caregivers? Which hospital will be better prepared to handle complications or the unexpected?

In-order to move into a healthcare model of the 21 century we have to be open to the idea of change and look for new opportunities in how to deliver the best care possible to each and every patient.

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