Catskill Regional Medical Center (CRMC) is the county’s only public hospital. To that extent, it is of paramount public interest that it provide acceptable care to the people it serves. The questions that Dr. Hal Teitelbaum and his partners at Crystal Run Healthcare have raised about the quality of care at the hospital can be seen as providing a useful, even necessary, social function, opening a dialogue about how CRMC is performing and how it might perform better. This is especially important because most laymen are in a poor position to judge the medical care that they receive, whereas the professionals at Crystal Run presumably have the training to be more discerning.
But the fact that CRMC is the county’s only public hospital also makes it especially important that we not throw the baby out with the bath water. A scorched-earth policy that merely leaves the institution weaker than it was to begin with will help nobody.
It should not be forgotten, moreover, that, shamefully, in the United States of America, public hospitals are our only medical safety net. The world’s other developed countries provide health insurance for all their people, score higher on measures like life expectancy and infant mortality, and pay a fraction of the cost per person that we do. In those countries, there is no one type of institution that has to bear a disproportionate share of the health-care burden.
In contrast, in America the only recourse for the large and increasing proportion of the population that is un- or under-insured is the public hospitals. Nationwide, the number of uninsured runs at about 15 percent of the population; we were unable to find an estimate for Sullivan County, but to the extent that the percentage of coverage varies with income, and our average incomes are below the national, it can be assumed that figure may be even higher. However superior the care might be at Crystal Run Healthcare, the cold hard truth is that there are some people in this county whom they will simply not serve. To aggrandize such private institutions at the expense of our safety net would not be a wise move.
The fact that the hospital gets stuck with uninsured cases also means, of course, that it has a hard row to hoe in balancing its income with the services that it is mandated by law to provide. That doesn’t mean we shouldn’t work as hard as we can to improve the level of care there, and to fix any problems that emerge. But it does mean we need to be realistic about what we can expect from the institution relative to what we are demanding from it.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) apparently saw no egregious problems at CRMC at its last regular review in 2004, as it granted it accreditation at that time. It is now re-evaluating CRMC “for cause,” which is to say, on the basis of complaints, most of which are Teitelbaum’s. Whether or not the complaints are substantiated remains to be seen. It is our hope that if problems are found, the hospital, the community, the doctors at Crystal Run and any other private facilities in the county can find a constructive way to work them out that does not wind up damaging this vital part of our community structure.
If, on the other hand, the accreditation agency clears CRMC of any accusations, we would hope that the current war, which is draining the time and attention of medical care professionals whose time would be better spent on sick people, could simply be called off.
Dr. Punnybone
This Just In!
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The physicians of Crystal Run Healthcare recently resigned their privileges at Catskill Regional Medical Center (CRMC) because of concerns regarding patient safety and quality of care. As physicians, we feel that this step is necessary because, in our judgment, the cultural climate of CRMC does not appropriately and adequately value patient safety and quality of care.
We believe that this climate has been fostered by the lack of appropriate leadership on the part of Catskill’s Chief Executive Officer and Board of Trustees, a leadership that has attempted to take the focus away from serious patient health and safety concerns by denying that it has any quality of care concerns, making accusations about a power struggle and taking pot-shots at Hal Teitelbaum, our managing partner.
