To the editor of THE EAGLE:

Stroudwater Associates, who have been retained as consultants to advise on the future of North Adams Regional Hospital, conducted a public meeting last Tuesday in North Adams to gather input from the community. Many spoke of the health, social and economic needs in the community, as well as of its geographic isolation. It is clear that the community has been adversely affected by the loss of hospital and the jobs it supported.

However, the testimony lacked recognition of the factors that have impacted health care delivery over the past 25 years. Nationally, hospital admissions and lengths of stay have declined steadily in spite of an aging population. Without a critical mass of patients, to justify 24/7 staffing, inpatient hospital services are not viable.

The economic forces that power consolidation in many enterprises also apply to hospitals and physician practices. Primary care physicians, supplemented by specialist consultations, diagnostic testing, and/ or emergency/urgent care, can manage health care for most people. Large physician practice groups provide their own urgent care centers during off-hours and weekends, thus further reducing hospital use. The driving forces in health care have been oriented toward replacing inpatient with outpatient care, fragmentation with coordination, and sickness care with prevention.


Advertisement

Twenty-five years ago, when Fairview Hospital in Great Barrington recognized its vulnerability and inability to maintain sufficient volume for a full range of inpatient services, it decided to join with Berkshire Health Systems to help it rationalize health care delivery for southern Berkshire and to provide services based on community need. Unfortunately, North Adams long ignored the warning signs of these trends, making investments that could not be justified by patient volume or rates of reimbursement. The ubiquitous "Save Our Hospital" signs represent false hope for the return of a full-service hospital in North Adams.

It is essential that we develop a model for health care that meets our needs and is economically sustainable. Our northern Berkshire community wants high quality, well-organized services, whether or not that involves the restoration of inpatient beds. Moving ahead, means identifying those needs, and developing comprehensive services, drawing on expertise in other locales, and including outreach and transportation services, if necessary.

MARGOT S. MOOMAW

Williamstown

The writer is a former vice president of marketing and planning for BMC/Berkshire Health Systems and subsequently for New England Baptist Hospital in Boston.