My hospital

Issue: BCMJ, vol. 52, No. 2, March 2010, Page 60 Editorials

It’s not really that impressive—painted concrete walls, nondescript rooms, lighted hallways. Simple enough, but when put together in the right proportions it makes up my hospital. It is a very generic building, but I have a fondness for it as I have spent 19 years managing its nuances. In those years I have seen it change, and not in the ways you would think.

What I find most amazing is that the population in my community has grown by 50% and my hospital has been able to manage this influx in demand with the same number of hospital beds and doctors. Somehow I don’t think this achievement is related to improved operational efficiency. Something is not right here. 

Other things I have noticed. Rooms are now coed, often with self-conscious seniors of different gender separated by a thin curtain as they are bathed and toileted. Meals are no longer prepared in the hospital kitchen. These preserved meals are prepared elsewhere (try another province) and rethermalized on site (“reheat”sounds so 19th century). The scrambled eggs have an unnatural yellow glow, which perhaps serves the dual purpose of saving on heating and lighting costs.

Cleaning and laundry services are now being outsourced to private companies. Even the cafeteria and its hospital workers have been replaced by a privately run establishment. In the past my colleagues would often meet in the cafeteria for coffee after rounds were completed. I went down to the cafeteria the other day and there was not a doctor to be seen. 

Speaking of physicians, if you look at the stats the number of specialists has increased but the number of GPs with hospital privileges has decreased. We now have hospitalists who manage the majority of our inpatients. I have nothing against my hospitalist colleagues, but they are shift workers whose job is done when the patient is discharged. 

The doctors’ parking lot is now only reserved for physicians during certain hours and then, except for a few spaces, open to all paying custom­ers. Speaking of paying, my yearly parking fees went up 30% this year. I think the memo stated that the in­crease was for “landscaping, lighting, and security.” I am still waiting for some guy with flowers in his hair to be standing there holding a gun and a flashlight. If I don’t want to pay I always have the option of parking on some quiet side street. Oh, wait a second, they put up “no parking” signs to terminate this clearly criminal behavior. 

Our logo has changed at least four times (the original logo, Langley Mem­­or­ial Hospital, sufficed for 48 years). Every morning I find my hospital right where I left it the day before, but our region and health authority seem to be in a constant state of flux. I wonder how many trees have been victim to logo changes.  

Over the past two decades my hospital has changed from a predominantly GP-run institution with a strong sense of community to an apparent satellite unit of a huge health region. The stakeholders and powers that be don’t seem to have the same local interest or passion for our town. Sadly, many of them aren’t residents and associate our community with the stretch of highway they drive through on their way to work. 

One largely unappreciated constant is the people at my hospital. The doctors, nurses, pharmacists, physiotherapists, occupational therapists, and more continue to work hard and strive to provide more with less.  I am proud to call many of them my friends and acquaintances. Often, I draw from their strength and am motivated to pick myself up and stop being so negative about the changes I see. 

This is my hospital. Sound anything like yours?

David R. Richardson, MD. My hospital. BCMJ, Vol. 52, No. 2, March, 2010, Page(s) 60 - Editorials.

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