What you need in a hospital

In an earlier post I discussed what we need in a Congenital Heart Surgeon. Reader Heather let the cat out of the bag by mentioning that wasn’t all you needed… you need a good hospital, too.

How true, how true. As I have said many times before, the doctor you need does not practice in a town of 5,000 people. There aren’t enough patients in the community to allow him or her to sharpen their skills. Skill partially depends on volume – you do something often, you do it right, and you evaluate your results (and you keep evaluating them, constantly). That’s the only way to improve. You learn from someone who is experienced, then you do it yourself, knowing that anything less than 100% is unacceptable. As you gain skill, you learn how to do it better and faster.

That same fact applies to the hospital. You can have the best surgeon that ever put on a mask; but if the hospital you are in has very little experience with caring for post surgical patients, there could be problems. That applies to the type of surgery you are having, not to all surgeries. Caring for someone who just had heart bypass surgery and someone who just had congenital heart surgery is a lot different. Studies prove that the more experience a facility has, the better the outcome.

I love my community hospital. We have about 150 beds and I’m on a first name basis with a lot of the people there. I know the doctors and the nurses not only from the hospital, but I see them in the community. I saw one of my favorite nurses in the grocery store just last week. But that doesn’t mean I’m going to let them do heart surgery on me – they don’t have the skills. They are well-meaning people and I am sure they would do their best, but if I had surgery there, I’d probably come home in a box. We can’t have that, I’m claustrophobic!

A few months ago there was a plan being considered by England’s National Health Service to consolidate the number of Pediatric Heart Hospitals. A good number of people were understandably upset but the reasoning is logical: some of the units performed a relatively small number of surgeries. Consolidating the number of centers may make it inconvenient for some, but it will make the overall results better.

For us here in the States, that probably means a trip to a large city hospital. There are exceptions – Durham, North Carolina  (the home of Duke University Hospitals) is fairly small and Rochester, Minnesota (Home of the Mayo Clinic) is also a small city. But in most cases, we’re heading to The Big City – New York, Los Angeles, Nashville, Boston, Birmingham, Kansas City, Denver, Atlanta. These are only some of the destinations whenever the Heart Warriors I know head to the doctor. “Medical Tourism” is all the rage right now, but to us its old news. The average Heart Warrior is also a Road Warrior; we’ll go to where the best hospitals and doctors are.

And in the words of that great philosopher, Bruce Hornsby – That’s just the way it is.

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6 Responses to “What you need in a hospital”

  1. heather Says:

    this is exactly why i love having 2 hospitals watching asher. the cardio team 20 mins from here doesn’t have a surgery programme, but they deal with heart kids from all over south-western and western ontario (that’s a lot of territory!!!). and we’re also followed at sick kids in toronto. that’s where asher has had all his heart surgeries and caths (10 altogether), and we’re followed by the amazing cardio’s there, too (i think there’s only 1 left that we haven’t met yet, but they all know asher very well). i’m happy to go to london for basic follow-up, pacemaker clinic, that sort of thing. but as soon as anything goes wrong (and it inevitably does in asherland), i’m on the phone to toronto. london just isn’t set up to handle asher and his complications. he does weird and unusual things, and london just doesn’t have the experience. so toronto it is! 🙂

  2. Jamie Says:

    Same here Heather! We have a small clinic w/two cardiologists & 1 nurse that we go see 1x a year. He’s the one that made the diagnosis. And then we see his cardio in Dallas 1x a year also. So he’s getting seen every 6 mos., but by two different drs & it has worked out great for us! But for treatment, we go to Dallas (6 hrs fr/where we live!).

    And Steve, I have to remind you that you did not have Dallas on your list of great places to go for CHD surgery! (HA!) They have an amazing surgical program that was initially started way back when by Dr. Nikaidoh & Dr. Leonard (which performed my son’s surgeries). They have since moved on after many many yrs of being at Children’s Medical Center of Dallas & now are heading up cardiology departments in other children’s hospitals (Tulsa & Denver). I figure if you have a procedure named after you, you’re a pretty good dang surgeon (the Nikaidoh Procedure is an Aortic Translocation and is now the preferred method when dealing w/TGA)!

    Even though I’m not from Dallas, I know the stretch of I-35 from Harry Hines Blvd. to Motor Street VERY well and have stayed at almost every hotel and ate at every restaurant in the area! Our son is for sure a Road Warrior. We need to come up with a new name for guys like him! Any suggestions?

    • Steve Says:

      Well, I mentioned the destination cities of people I know – and myself (Atlanta). I just don’t know anyone of anyone who went to a hospital in Dallas. That doesn’t mean they aren’t a good hospital, just that I didn’t know of anyone who was a patient there!

  3. Jolo Says:

    indeed!

    “The true genius shudders at incompleteness – and usually prefers silence to saying something which is not everything it should be.”
    Edgar Allan Poe

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