Thursday, April 01, 2010

Hospitals Worth the Trip

Medical travel, popularly referred to as medical tourism, usually means foreigners coming to a hospital in the United States for a procedure or US citizens going to hospitals abroad.

However, when someone in Fort Worth drives fifty miles to Dallas' Baylor University Medical Center, that is medical travel as well.

Medical travel happens when a woman leaves her own neighborhood, where there is an acute care hospital, and goes to another hospital outside her neighborhood. It can be travel within a community, city, county, state, or country -- or outside the country.

People are medical travelers when they pass by a local hospital that offers the same procedure as the hospital to which they travel. It is understandable when people pass by a local hospital that does not offer a procedure, treatment or test that the distant hospital provides. That is medical travel too.

A hospital in Orangeburg, South Carolina that offers maternity services is concerned when a healthy woman from Orangeburg travels to Columbia, South Carolina for what is expected to be an uncomplicated and normal vaginal delivery. If the woman expects to have a difficult delivery or the mother or fetus has health problems, then it is understandable if an Orangeburg resident travels to a hospital in Columbia where there is a neonatal intensive care unit.

What makes travel to a hospital outside your neighborhood worth the trip?

The status of "worth a special journey" (***) has been used for years by the Michelin Guide to characterize the very best restaurants. Their next lower rating is "worth a detour" (**). This is followed by "very good" (*). The lowest rating, with no asterisks but recommended, is "good at moderate prices". While some may disagree with the ratings, the person in search of a dining experience, in a city in which he or she is unfamiliar, is likely to have a pleasant meal when they go to any Michelin-rated restaurant at any rating level.

Michelin may someday rate hospitals worth a special journey. In the meantime, the hospital industry has a variety of rating services to help us find our way to that one hospital out of many that is worth a special journey.

Recently Thomson Reuters released its list of the 100 Top Hospitals for 2009. Last year, US News & World Report published its list of top hospitals. Some hospitals, like the Mayo Clinic, appear in nearly every list, regardless of the source of the list. Sometimes there are surprises, hospitals that are not known to be exceptional either within a region or within the country.

Who are we to trust? What about our local hospital that is not on either of these lists? Should a man travel to a top one-hundred hospital that specializes in prostate surgery to get his prostate removed? Or take a chance at a local hospital that just installed the latest robotic prostate removal device? Each list-maker has its own criteria and valid reasons for using either hard data such as infection rates and costs or soft data such as physician opinion. Many hospitals not on the list are quick to challenge the list's validity. Hospitals making the list are quick to get the rating posted on their web sites.

Are these top 100, regardless of which list we are looking at, really worth the trip? Is your local hospital worth the trip?

I am asking hospital marketing and public relations directors to tell me why their hospital is worth the trip.

The public relations director at a rural hospital with less than 100 beds tells me that her hospital is not worth the trip. It exists, she says, just for the people in the community. She notes, however, that she is concerned that people from the small town where her hospital is located are going to a hospital in a nearby city. The city hospital is, apparently, worth the trip.

A hospital in a mid-sized city says it offers many services and really cares about its patients, making this hospital worth the trip for most nearly everyone.

A large tertiary teaching hospital's President tells me that his hospital is worth the trip for specialized procedures that are not offered at smaller hospitals. He advises residents in other towns to use their local hospital's services for less specialized procedures.

A well-known hospital in Bangkok, Thailand says the hospital is worth the trip because of the specialized treatments, board certified physicians, American administrators, high volume of procedures performed, good outcomes, low infection rates, short recovery times, high patient satisfaction, excellent customer service, and costs lower than those in the US and other countries.

What, if anything, makes the hospital you work for, have worked for, are affiliated with, or have used -- worth the trip?

Shouldn't every hospital have at least one carefully documented quality that makes it worth the trip?

One rural hospital, unremarkable in most respects, has a celebrated lunch buffet in its cafeteria that packs in local residents and those from nearby towns every Sunday. Another hospital has a museum of surgical devices in its lobby. Still another exclusively serves American Indians but welcomes visitors to view its exhibits of one tribe's art, artifacts and culture. Another hospital has a convention center and retail shopping mall that serves the community.

Let's hear the viewpoints of patients, hospital staff, volunteers, doctors, nurses, techs, administrators, attorneys, board members, public relations and marketing directors, people whose relatives and friends who have been in a hospital, employers, insurers, pharmacists, and other who have had experience with the hospital.

Can you make a compelling argument, with documented evidence or just platitudes, for your hospital as a destination for the medical traveler? Except for the most frail and poorest among us, travel to a hospital across town, across the country or across the ocean is an option. Insurance companies are promoting travel and will assist their members in making the trip.

Comment below about why your hospital is worth the trip or, if you prefer, simply email me. If you include your phone number, I'll call you. I'll compile the results from all sources and let you know what I hear.

What makes your hospital worth the trip?