Constant change in health care


Publisher John D’Agostino finds “No quick cure for what ails Brooks” Memorial Hospital (May 2).

The symptom is expressed concern about hospital job security secondary to a continuing decrease in in-patient days. D’Agostino diagnoses management failure. The treatment plan has yet to be formulated.

Victor R. Fuchs (New priorities for future biomedical innovations. New England Journal of Medicine, 2010, 363, 704-706) documents changes in life expectancy throughout the 20th century due, earliest, to improvements in nonmedical factors (”nutrition, sanitation, housing, and public health measures”) and, later, to biomedical innovations (”new drugs, devices, and procedures.”) Both continue.

At 5 years of age, I often visited children in iron lungs at county-operated Newton Memorial Hospital where my mother was a teacher.

The hospital was clean, light, and airy, with splendid hilltop views over upper Cassadaga Lake. But the hospital closed to become, eventually, the Cassadaga Job Corps Center, not because of mismanagement but because “new drugs, devices, and procedures” virtually eradicated tuberculosis, the disease that the hospital had been created to address, as well as polio. The physicians, nurses, and hotel staff moved on to other work.

Health care has been in constant flux throughout history, and Fuchs sees no end to this. All of us need to consider this.



Quality assurance manager at Presbyterian Hospital, New York City, from 1988 to 1989.