IMAGINE THAT ONE night, you come down with severe abdominal pain. You head to the emergency department, where a CT scan reveals an inflamed gallbladder requiring urgent surgery. But instead of heading to the OR, you lie on a cot in the hallway, waiting for hours, in pain, alongside other patients in distress.
Around you is a family comforting a crying child, an elderly patient moaning in her cot, and the ceaseless movement of nurses, doctors, and emergency room staff. However, none of them can tell you when your pain will be relieved, or when a surgeon will see you. Eventually, you learn that you will have to stay overnight in the emergency department and, if you are lucky, see a surgeon and get a hospital bed in the morning.
What if your condition worsened—would you see a surgeon any sooner? Now imagine: the state allows one of the hospitals in your community to close, and now there are even fewer hospital beds to go around.
This is the current reality facing many hospitals in communities where hospitals run – and pillaged – by Steward Medical Group may soon close. This scene — patients boarding for hours or even days in the emergency room — is something we see daily in emergency rooms across Massachusetts.
Our health care system is under-resourced and overburdened. Every hospital and emergency department in the state, from small community hospitals to large academic medical centers, is affected by the reality that Massachusetts simply does not have enough beds for the number of patients. This is a statewide issue that demands actions from our statewide leaders. It’s time for the Commonwealth to reclaim health care as a public good.
When we are out of beds and forced to transfer or divert patients, we see the direct effects this has on people’s lives. Mothers deliver infants far from their families. Patients face additional wait times for ambulance crews. Underinsured patients may be turned away from hospitals that don’t accept their insurance.
In Lawrence, where we work, the closest specialized care hospitals are 45 minutes or more away. This is often an unacceptable amount of time to delay care for critically ill patients. Yet, that is the question we are forced to answer—who will have access to our very few resources, and who will miss out?
Transferring patients still does not solve the problem of not having enough beds. Our fellow resident physicians and union members at Boston Medical Center attest to the same overcrowding and capacity issues. Now, our whole medical system is dependent on the uncertain fate of the now bankrupt Steward Medical Group and the sale of their hospitals that will likely result in the closure of some facilities.
If even one of these nine facilities closes, dire impacts will be felt throughout the state. Patients with treatable, preventable illnesses will suffer higher morbidity and mortality from lack of access to care. Our medical staff, already asked to do more with less, will be tasked with finding ways to care for thousands of additional patients. People, maybe even you, will find themselves waiting longer in the emergency room to access a hospital bed and care.
The Steward crisis also jeopardizes the future incoming health care workforce. Steward hospitals host training programs for doctors and nurses, including residencies at St. Elizabeth’s, Carney, Good Samaritan, and Holy Family hospitals. Closing these hospitals could result in the loss of thousands of physicians and other medical professionals who would otherwise be in Massachusetts.
Staffing shortages and overcrowding already contribute to burnout among colleagues. This burnout is fueled by long hours, lost sleep, and time away from loved ones while being under-resourced and unable to provide timely, affordable care to patients. We cannot bear any more.
The current capacity crisis is ultimately the result of a health care system perverted by profit incentive. If the Steward hospitals close, we will see staffing shortages and overcrowding not seen since Covid, and this time there won’t be a vaccine to save us.
It is imperative that our government step in and reclaim health as a human right and hospital beds as a public good. The state should provide financial support to facilitate public ownership, and start the Commonwealth back to the path towards publicly owned hospitals and health centers. We must leave these for-profit actors behind.
If there are no bidders for a specific site at the Steward auction, the state should be prepared to use all of the tools in their power, including seizing property by eminent domain, to ensure these beds stay open. As the leaders in one of the wealthiest states in the country, it is squarely the responsibility of our elected leadership in Beacon Hill to save our hospitals.
The state has a duty to protect every single bed at every hospital, for the sake of our communities, our patients, and our health care workers. In the midst of a capacity crisis, it is unconscionable that any community faces the prospect of losing a hospital. After all, what good is Massachusetts’s purported world-class health care if patients cannot access it when needed?
Jack Gordon and Ryan Huff are physicians in family medicine practicing in the Merrimack Valley and union members of the Committee of Interns and Residents/SEIU.
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