During the past several years, specialty hospitals have been getting a lot of attention in the media, not much of it positive. The staunchest critics point to potential conflicts of interest involving physician ownership and the complaints surrounding the types of cases these hospitals accept. While I dont see this debate subsiding in the near future, I hope to contribute to a broader recognition that not all specialty hospitals are alike, that in fact there really is no specialty hospital industry, and that among the models of niche facilities are many that contribute greatly to innovation in healthcare delivery and ensure the highest levels of quality and outcomes.
With such a wide array of structural and organizational models, one could argue that the only thing that all specialty hospitals have in common is that they have a focus on one aspect of healthcare. In terms of differences among specialty hospitals, they may be large or small, for-profit or not-for-profit, free-standing or part of another system. Some are academically oriented. Traditionally, our industry is familiar with specialty hospitals in the form of childrens hospitals, cancer centers, rehabilitation hospitals and psychiatric facilities. More recently, so-called centers of excellence in other specialties have begun to dot the healthcare provider landscape.
As the chief executive officer of Hospital for Specialty Surgery in New Yorkthe nations first and only not-for-profit, academically oriented, free-standing musculoskeletal hospitalmy perspective of a specialty hospital is perhaps unique. Since its establishment in 1863, HSS has cared for the orthopedic and rheumatologic needs of patients from across the U.S. and around the world. Our team of almost 300 active medical staff members offer a comprehensive set of services in every area of orthopedics, rheumatology and related services.
In further support of our mission to improve the mobility and enhance the quality of life of patients, HSS is actively involved in musculoskeletal research and education. There are more than 100 residents and fellows in musculoskeletal specialties, and our basic and clinical research programssupported by 82 full-time scientistshave brought us closer to discoveries like deciphering the underlying disease mechanisms of rheumatoid arthritis and understanding prosthetic loosening after total joint replacement. Community service is also a critical part of our mission, providing world-class services where access might otherwise not be achievable.
While I would not suggest that any one organizational model is better or worse than another, I do believe that many specialty hospitals (and by extension, their patients) benefit from their focus on caring for a specific condition or disease category. Since its debut in his seminal article in the Harvard Business Review in 1974, C. Wickham Skinners basic principle that concentration and repetition beget quality and efficiency has been applied throughout healthcare.
HSS, with its focused, multispecialty approach to a patient population with musculoskeletal-related problems, serves as a good example. In 2007, HSS orthopedic surgeonseach of whom is subspecialized in a specific subspecialty of orthopedicsperformed more than 20,000 surgeries across 28 operating rooms. This level of specialization is just one factor that contributes to exceptional outcomes, including a 48-hour post-surgical mortality rate of zero and an overall surgical-site infection rate well below the national average for similar procedures.
To be clear: I am neither questioning the ability of general acute-care hospitals to produce high-quality outcomes, nor would I suggest that all specialty hospitalsby their focus alone or for any other reasonare the paragon of quality, patient safety or service. Rather, as the debate continues, I merely hope to paint a more complete picture of the range of organizations that fall within the specialty hospital umbrella.
Like the universe of acute-care hospitals and other forms of healthcare delivery systems, some specialty hospitals can achieve extraordinary results. Lets make sure we are cognizant of the value that alternate forms of healthcare delivery can contribute before we paint them all with the same broad brush.