In an 1889 essay, The Decay of Lying, Oscar Wilde argued that life often imitates art because “the self-conscious aim of life is to find expression,” and art provides an appropriate release. In many ways the same could be said of the current relationship between those who provide health care to the community and those who draft legislation governing such care. As the debate around health care reform enters its second year, perhaps it is time to stop and consider the full impact of the bill, not just on the health care system as a concept, but on the fate of the local hospital as a living, breathing entity.
The obvious uncertainties brought to life by today’s health care climate have over time become an unfortunate source of anxiety affecting nearly every patient-doctor relationship, as well as giving pause to the hundreds of thousands of health care workers industry-wide. For those on either side of the equation, the future of these relationships is now at a crossroads, in large part because neither professionals nor patients know what may be waiting around the next corner. Sadly, this all too often adds undue pressure to the already difficult task of care for the sick in the event of an emergency.
Next month will mark my nine-year anniversary as CEO of a hospital in Los Angeles County, California, in a role I had honestly never expected. I remember walking into that job on my first day, to face a group of intelligent, dedicated hospital managers who were devastated by the loss of their former leader. As I addressed this room full of people - some of whom were in tears, some of whom remained stoic, all of whom were scared of what the future might hold - I wondered how I could ever comfort them for the loss they had just endured and assuage their fears of what was to come. The Hospital’s former CEO had died the day before from injuries sustained in a car accident, and it was my job to regain control of the facility and keep things functioning while learning the ropes as I went. There was no question I had some rather large shoes to fill, and but for the fact that the prior CEO had also been my father, I imagine I never would have accepted the challenge.
On the day of that first meeting with my new staff, we did not focus on our need to provide health care to the surrounding community. Instead, we addressed the obvious issues of how best to continue forward as a team. Even so, no one working that day forgot the primary goal of any hospital, regardless of the surrounding chaos. Notwithstanding, for the next 3,300 consecutive days - almost 80,000 uninterrupted hours - the hospital did exactly as it should, using the network of relationships already in place and building on the new to continue its focus on providing care to the community. In hindsight, the past nine years under my tenure were in many ways defined by these relationships, and our focus was strong. As a result, the community received exactly what it had come to expect and deserve -- a hospital.
Five months ago I began what would become a new chapter in this story, although initially I had no reason to anticipate the scope of its impact. It had become increasingly clear that the time had come to enter into discussions to sell the hospital to a larger health care group with the resources necessary to continue providing the area with top quality care. Throughout the process, which was long, arduous, and quite emotional for me, our focus was always to ensure that the community received what it deserved -- that same hospital it had come to rely on for over fifty years. Yet even in those moments when my focus waned, I knew I could depend on an extended family nearly 400 strong who made sure that we were well-positioned to deliver medical care to those who needed us. In the end, that’s what health care is all about.
Just the other day I entered that same room, filled with many of the same people from nine years ago. While there were plenty of new faces as well, most of them had long ago become a part of our family. I explained that I had been preparing for this day for nearly nine years, although what was originally a day to which I had looked forward with anticipation was now one I truly dreaded. This time, I was to deliver a different message - that I would soon be stepping down as their leader. Looking out at the crowd as I gave news, every face reminded me of a lesson taught or learned, a favor asked or granted, or an experience shared.
I’ve heard it said that the whole is greater than the sum of its parts. When it comes to health care in the modern age that is certainly true, be it the correlation between community and hospital, employees and hospital, or even investors and hospital. As different as each of these bonds is from the other, all three survive only by existing together. These past few days I have witnessed first hand the ways in which change can make for a stressful environment. The staff is nervous, the patients may be confused, and emotions run high. Nine years of consistency will undoubtedly lead to fear and uncertainty for a time, no matter who is waiting in the “on-deck circle”.
But that is what makes a hospital such a special place to work. As chaos tries to rule the day, something happens, and a wake up call of sorts is given, reminding us all of the reason we have come together in this building on this day. Our dose of reality connects us with the real issue at hand. We remember that our community truly values the support we give in times of need, just as we do the same for one another. After all, that is what relationships are all about.
If life could really imitate art, or at least the spirit of the law, it would make health care reform a much easier pill to swallow. To succeed in this endeavor, our primary goal should be to remember not just why we are here, but what the underlying purpose of health care in America is really all about. For me, it has always meant faithfully serving the people who depend on us. Though we may all sometimes forget why we do what we do, the relationships around us that maintain the hospital infrastructure so that it can operate all day, every day, are too important to ever be taken for granted. Hopefully those who oversee the nationwide debate will one day come to accept this fact.