In Praise of Public Hospitals

Bellevue atriumPublic hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.

As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t afford, but many of these are cosmetic issues.

On the cosmetic side, though, public hospitals have come a long way. Bellevue Hospital, where I work, has built a gorgeous ambulatory care building, complete with a soaring atrium that floods the waiting areas with sun and space. The ICUs and emergency wards have been renovated to enviable standards.

But beyond cosmetics, there is an extremely dedicated staff who is committed to providing high-quality care, despite the many financial and logistic challenges that public hospitals face.

As a physician, this is something I have always been proud of. As a parent, I recently had the opportunity to put this to the test. Earlier this week, my six-year-old son was hit by a bicycle while crossing the street. Luckily, he wasn’t severely injured, but there was a nice-sized laceration in his scalp that clearly needed stitches.

Although the private hospital in our neighborhood is “top-tier” for my insurance plan, I decided to take my son to Bellevue instead. The main reason for my choice is that Bellevue is one of the few hospitals that has a dedicated pediatric ER, instead of just a small section within an adult ER.  I’ve spent enough time in emergency rooms to know how disconcerting they can be to anyone of any age!

As I walked my son to the pediatric emergency room, I tried to look at my hospital through a visitor’s eyes. The facility was modern, clean, and spacious. The pediatric ER was quiet and calm, so unlike the adult ER. There were several families there, but the waiting room was big enough for each family to have some privacy. The walls were lined with toys, posters, games, and a huge fish tank. My son was riveted and completely forgot about the bleeding wound on his head.

We were evaluated by a pediatric triage nurse, and then had a smooth registration process. I marveled at how subdued the atmosphere was, compared to what I knew regular ERs were like.

When we were called in to see the doctor, my son had to be pried away from the fish tank. In the exam room, my son was evaluated by a pediatric attending physician, along with a pediatric resident and nurse. There was also a child-life specialist in attendance, someone whose job it was to be there solely for the child—whether to fetch crayons and books, or to act as the child’s advocate should the situation arise.

I was impressed by the professionalism of all the staff, and the fact that everything in this ER was geared  specifically toward children. In a situation that could easily have caused anxiety in a small child, my son was well cared for and felt completely at ease. I am aware that such things do not happen by accident, that they are a result of the attitude of both the individuals and the institution.

I know that the fact that I am an employee of the same hospital may make some think that I received extra-special service. But I observed the other children and families who were there with us. Everyone was treated respectfully, expeditiously, and competently. The physical surroundings were comfortable and reassuring.

I walked away from the experience proud of Bellevue and proud of public hospitals in general. Public hospitals are the unsung jewels of our health-care system. They are easy to denigrate, but are often models of clinical excellence. They can be places that patients prefer to go to, or they can be places that patients go to only for emergencies.

But public hospitals are always there for us. This alone is a reason to celebrate them. That they deliver excellent medical care to one and all should make us justly proud.

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Danielle Ofri’s newest book is “What Doctors Feel: How Emotions Affect the Practice of Medicine.” She is an associate professor of medicine at NYU School of Medicine and editor in chief of the Bellevue Literary Review.

 

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