I would like to entitle this letter, "I am proud of my brother." Family is a funny thing sometimes. I grew up in rural Missouri in the shadow of an older brother who was incredibly bright and talented. As in many sibling relationships, we were competitive and were often critical of each other at times, amidst trying to meet the seemingly unrealistic expectations typically exhibited by Asian-American parents. Even while we were roommates in medical school, we still had a healthy spirit of sibling rivalry. Today, my brother is an accomplished attending psychiatrist at the University of Pennsylvania. Looking back at his success, I realized that I could recall few times throughout our lives where I could remember congratulating him or telling him how truly proud of him I was. This reminded me that we often are most critical of the people who are closest to us.
I moved to Marietta 18 months ago where I accepted my first attending job as a surgeon at Marietta Memorial Hospital. I met my wife in Chapel Hill, N.C., who was from a small town called Marietta. I had never heard of it. With time, we eventually decided that this is where we wanted to plant roots and raise a family. I came from the "ivory tower" and prominent institutions that are frequently referred to as "centers of excellence" internationally. I have spent my entire medical career in these institutions and know the good and the bad that come with being a patient in those institutions. During my brief period of time thus far in Marietta, I cannot begin to describe what I have witnessed being accomplished here locally. In many ways, it is almost unimaginable what this medical community has been able to accomplish for its size not only from a quality perspective, but also from the level of subspecialty care.
As a physician, we are judged by many "quality indicators" and are compared to our peers nationally. Our programs are excelling in this arena as evidenced by accolades given to the cardiology and orthopedic services, recently named top 100/5-star rating by Healthgrades nationally. However, we are also judged by scores from patient satisfaction surveys and I have a hard time understanding why our patient satisfaction scores do not correlate with our clinical quality awards. I see the same faces walking the halls at MMH who also walk the halls at the ivory tower doing the same patient care tasks seen at any other hospital. But for some reason our community does not see our hospital, which is staffed with their friends and neighbors, to be as good as other healthcare providers in other communities. So why is there a disparity between patient satisfaction and clinical outcomes?
As many of you know, there has been recent press regarding the elimination of employed positions in the Memorial Health System. This is a reflection of being charged with providing the same level of care in the face of decreasing reimbursement by the federal government. As we have seen recently, there are hospitals that are closing locally as well as nationally as a result of this increased financial pressure. The mechanisms for reimbursement for hospitals have evolved into "pay-for-performance" and one major indicator is patient satisfaction. What is happening is our hospital is getting paid less because our community does not perceive we are performing well. I recommend that it is time to propose a radical idea: begin to tell our brothers, sisters, and families that we are proud of them for what they have accomplished. Why? Because it is a matter of whether or not our families have a hospital here in the future to care for their loved ones. This community has become my family and I am proud to call it my home. I have cried, toiled, and celebrated with you and it is an honor to care for so many of you. When I am sick, I want to see my neighbor standing there waiting to take care me, not be sent to Columbus to be cared for by a stranger. I just hope that I have the opportunity to do it for many years to come in the community that I now call home.
Rajendra Bhati, MD, is staff surgeon at Marietta Memorial Hospital.