Partnering with community hospitals is certainly better than duplicating resources and building specialty hospitals in markets where there are already too many beds and excess capacity for surgery (Guest commentary, A Lone Star state no more: Room for specialty hospitals, May 5).
Having grown up and started my career in Minnesota, I found it very surprising that the only historical reference to doctors building and starting hospitals that the authors could cite was to the Mayo brothers. The authors need to brush up on their history. The Mayos (father and two sons) did not put up their own money to start the first hospital in Rochester. This was done by the community and the Sisters of St. Francis. Indeed this was a partnership, but it was a partnership where the physicians directed medical care and partnered with this religious order and the larger community to ensure a hospital was available for all of the community who were sick or needed surgery.
Full-service hospitals (community or for-profit) built today or in the past do benefit from the input, ideas and suggestions of the medical staff that work there. The real Mayo story has been replicated all across this country.
Physician-owned specialty hospitals that have increased since the early 1990s in states like Texas have done so because physicians want control and more incomenot to innovate and improve care.
We all will agree that having surgical patients and their doctors not being inconvenienced by trauma patients, sudden emergencies and other inefficiencies surrounding the inherent community mission of full-service hospitals can certainly lead to improved patient satisfaction and possibly the impression of higher-quality care.
This is not innovation. Community hospitals across this countryespecially in the Midwest and Minnesotahave many more examples of physicians and hospitals working together to improve care and innovate without physicians owning the majority or a large share of specialty hospitals with 20% to 40% profit margins.
It is also interesting to note that the current Mayo system is an example of physicians, hospitals and the larger community working together under a governance model where no employee or physician receives a bonus or extra incentive to innovate and do what is appropriate for improving care and serving patients.
Peter ThoreenPresident and chief executive officer St. Lukes Regional Medical CenterSioux City, Iowa