Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, February 12, 1995 TAG: 9502110006
SECTION: EDITORIAL PAGE: G-2 EDITION: METRO
SOURCE:
DATELINE: LENGTH: Medium
Indeed, as noted in today's installment of our "Peril and Promise" series about the region's future, the Carilion system has become the Roanoke Valley's biggest employer. The hospital company's president, Tom Robertson, has even supplanted executives of the former Norfolk & Western Railway and Dominion Bank at the pinnacle of the community's business leadership.
Karl Miller, president of Lewis-Gale Hospital in Salem, does not see health care as a major growth industry in our region. His prognosis may well be accurate, particularly for hospitals. But efforts are being made, and new ways should be found, to sustain a healthy health-care hub for Western Virginia.
Many would prefer not to think of medical providers as businesses. Yet, whether for-profit like Lewis-Gale or not-for-profit like Carilion's hospitals, that is what they increasingly act like, and must be. Cost-control efforts arouse quality concerns in some instances, but generally are as inevitable as they are overdue.
Buffeted by winds of change sweeping through the business world, the health-care industry cannot help but find uncertainty infectious.
To a point, little can be done to reduce the uncertainty. As a service industry, health care depends more on the regional supply of customers than, say, a local manufacturer serving national and international markets. Health-care providers' fortunes are tied to the uncertain fate of the regional markets they serve.
On the other hand, local providers cannot escape relentless, external forces reshaping the nation's health-care industry. Washington is seeking ways to bring down soaring medical costs. Private employers across the country are doing likewise, in the marketplace. Health care will never be the same.
In the managed-care future already upon us, employers and insurance companies won't subsidize long hospital stays and unlimited tests and procedures. Hospitals, forced to compete and negotiate for the business of insured employees, will continue to find themselves in a downsizing, reinventing mode. Inpatients are out; nurse practitioners and physician assistants, offering basic care in lieu of more costly physicians, are in.
In the end, our region's existing bed capacity may prove too big. Specialty care may be siphoned off as in-state and out-of-state competitors, themselves facing the same economic squeeze, search more aggressively for customers. And pressures on hospitals to convert from charitable to businesslike ways may continue to loosen traditional obligations of social responsibility, such as hospital-paid care for the medically indigent and hospital-based training of health-care professionals.
But such possibilities should be met with neither panic nor passivity.
Aging Baby Boomers will be offering a steady supply of customers soon. There's a limit on how far people will want to travel for health care. And the trend away from an industrial model of big hospitals toward more flexible, niche facilities and home health care is, overall, a good one.
By building on local innovations and modest potential, our region could be a leader in such areas as expanding children's access to primary care; integrating information systems with health-care delivery; and providing flexible allied-health education that constantly adjusts to the fast-changing demands of the medical industry. Community Hospital's College of Health Sciences, for example, is a unique and invaluable institution serving the region; if a hospital-funded college is no longer feasible, surely the state or someone else should step in.
The local health-care industry can't, and shouldn't try to, become some sort of Mayo Clinic of the East. But building on health-education infrastructure already in place makes a lot of sense, as does preserving a medical-care hub in Western Virginia.
by CNB