Yesterday's posting raised some questions among some of my friends. In particular, they wanted to see the numbers. Here they are: Total abdominal (liver, kidney, pancreas) transplants for each of the hospitals in New England for 2004 and 2005. The number for 2006 only represents deceased donor organ transplants -- the live donor figures are not in yet.
Hospital -- 2004 -- 2005 -- 2006
BIDMC -- 124 -- 138 -- 86
MGH ---- 102 -- 153 -- 81
NEMC ---- 81 --- 65 -- 56
Lahey ---- 70 --- 75 --- 54
UMass --- 63 --- 71 --- 43
Children's - 20 -- 26 --- 26
Yale NH -- 63 -- 64 --- 62
Brigham --- 67 -- 65 --- 51
BMC ------ 29 -- 29 --- 27
RI Hosp --- 73 -- 76 --- 40
Maine MC - 66 -- 53 --- 52
DHMC ---- 36 --- 40 --- 43
Total -----794 -- 855 --621
There are multiple issues here, as I have discussed repeatedly (and probably ad nauseum to some of you!) One I have not mentioned is that smaller programs sometimes reject organs that are more problematic but usable because they don't have the technical expertise to handle the harder transplants -- and/or because they don't want to take the chance of harming their overall mortality statistics. This means patients listed in their locality have to wait longer for organs. So, is a small, local program always a good for the community? We often find ourselves in the position of being able to successfully use organs that have been rejected by less technically adept and/or more risk-averse transplant centers.
(By the way, although I include figures from Children's Hospital here, I recognize that pediatric transplants are a very special case and in no way would suggest that their program is too small.)
Subscribe to:
Post Comments (Atom)
5 comments:
Separate from any other aspect of this discussion, I applaud any centers that know their limits well enough to avoid attempting organs that they feel they're not skilled enough to handle.
If *I* were about to have such a transplant, you bet your booties I'd rather have them hold off until they're sure they can do it right.
On the other hand, my philosophy is to avoid that whole conversation by getting myself to a top-notch care center to begin with. I drive an hour+ to get where I want to be. I know not everyone has that option. But I imagine if I needed specialty care like a transplant, I'd still go wherever I have to.
As a patient, I would not want to have a complicated operation like a transplant done in a hospital where the surgeon is coming part-time from another hospital. The surgeon won't know the staff and the system and vice versa. This seems like a prescription for inefficiency at best and errors at worst. I wouldn't think the surgeon would like it so much either. Are there $ involved in these affiliations? And where will the surgeon be when I, the patient, have a problem? Will the surgeon be at my hospital or at his/her hospital? Aren't their rules about that - that is, doing surgery at one hospital and then leaving? And I agree with Dave that I would be willing to travel to a larger center like BIDMC to have my transplant.
Being a direct patient care employee at the transplant center at BIDMC, I often hear how patients appreciate that our center works well as the whole team is on the same floor.
Our main focus is patients, we have such a dedicated team here that we just don't clock out at 5!
We have patients that travel from New York or Western MA just for our staff and our reputation. Proud to be associated with BIDMC and the transplant center.
Rather than compare and contrast the respective strengths and weaknesses of community and academic medical centers I think it would be a more valuable exercise to focus on better partnerships between the two. I would guess that 70% of the hospital care in this country is provided by community hospitals and they do it very well. If we always took our gall bladder or hernia to an academic center they would be so over-run with volume that they could not handle the numbers. Also, lets' remember who trained the physicians and surgeons that practice in the community hospitals. What would be a limiting factor to better partnerships between community and academic medical centers? I suspect one would be a community hosptial that does not know its limitations as a facility and a medical staff. I suspect a second is the academic medical center that has the traditional view that partnership means "send us everything." Finally I suspect the third is plain old competition. I run two community hospitals in the Midwest (we do not do transplants nor do we want to) and would love to have a better relationship with some of the academic medical centers in our area but find it very difficult to cultivate.
Sorry you are not here. That is exactly the kind of relationship we try to have with our community hospitals!
Post a Comment