By Polly Keary, Editor
I've had Valley General Hospital and Providence on my mind for a long time these last months.
I've never felt like I really knew why the two deals the organizations approached never worked out. Nor have I ever been convinced that Providence isn't taking a bit more aggressive of a stance toward Valley General Hospital than they've let on.
So I've spent a huge amount of time trying to learn more lately.
The problem with trying to do investigative reporting right now is that there's a levy on. I want to write about what people are talking about, and they are talking about the hospital because of the levy, but I don't want to appear to be taking a position.
On the other hand, I do feel that I should do what I can to make sure everyone voting has all the information available.
So last week I ran the story about the emails that came to light that made it pretty clear that Providence nudged VGH fairly hard to go to an outpatient-only model during that last round of talks, before backing away when VGH declined.
This week voters will vote, and they may do what Providence didn't; end inpatient care in Monroe.
In any case, the story I run next week won't influence the outcome one way or another.
What I've learned is that Providence is rather aggressively encouraging their clinic patients to get all their care from Providence specialists.
That's not uncommon; it seems to be how hospitals survive in the changing health care economy.
Providence, like many other hospitals today, cite their internal medical records system as a compelling reason to get all care possible within the organization.
What I'm trying to learn is when that is valid and when it isn't.
Is "continuity of care" as defined by a streamlined medical records system so valuable that a patient should travel from Monroe to Everett to get a service they could have gotten at home? If so, when? And when does it make more sense to get a test done in town?
In trying to find out, I entered a world so Byzantine it would take a million pages to explain it; that is the American health care system.
There is so much going on behind the scenes when you go see your doctor that its as if the doctor's office is a theater stage, with a thousand stage hands and pieces of machinery behind the curtain, invisibly running everything you see.
In a way, untangling it all is a lot of fun. I won't get to use most of what I've learned, but I've enjoyed increasing my understanding of the system.
In another way, it's alarming. The system is a mare's nest of good intentions, unintended consequences, ethical issues, business practices, laws, logistical problems and strategy. And with the unfolding of the Affordable Health Care Act, it's also seriously in flux.
I pity anyone who tries to sort it out and improve the more glaring of its defects. It would be a bit like trying to untie a ball of snakes which knots itself up again just as fast as you untangle it.
One thing is for sure, there's far too much in play for there to be any black and white issues or bright lines.
But I still think I can get to the heart of the matter of continuity of care vs. convenience.
And that does have some bearing on the lives of people in this valley.
I'm interested to hear from you; is it worth driving to Everett for a CT scan? What about for surgery, or cancer care?
What is your experience?
I need all the information I can get.
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