Why Richmond Need a Childrens Hospital (Part II)

by Gayle Schrier Smith, MD
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“But I really want one, Mom!” he whined. “Maybe you should put it on your Christmas list.” I countered.
“It’s March 25, Mom. Christmas is exactly NINE months away! We could get a baby in that amount of time!”

And so my breakfast table conversation began. Everything takes time. There is not a mother among us who doesn’t fully understand the importance and the challenges of waiting. It’s true; you can get a baby in nine months! Things worth waiting for often take time.

The analogy holds true for many things in life. I hope that it will apply to Richmond’s full service children’s hospital. I’ve been waiting for one of those since I started my medical training and career as a pediatrician in Richmond twenty years ago. I’ve only known that hopeful waiting for a place where all the care a child could ever need would be provided under one hospital roof.

In the early 1990’s, VCU ushered in a new president and an era of expansion. He knew that other medical universities had a children’s hospital and that Richmond was a city whose size certainly could support one. Lots of community leaders actively explored the need (yes!) and the desire (yes! yes!) for a full service children’s hospital, but sadly they couldn’t arrive at a consensus and move forward to build one.

In 2005, with a new chairman for the department of pediatrics at VCU Medical Center, there was an announcement that Richmond would finally have a real Children’s Hospital. There were philanthropic community leaders who had pledged their financial support, and we were on our way! Eighteen months later, with very little fanfare and no public outcry, the plans were scrapped. What went wrong, and why did nobody seem to notice? Why was this happening to Richmond’s children again?

The answer is often unclear and difficult to discern. In Richmond, there are three health systems (VCU-MCV, Bon Secours, and HCA) that share equal thirds of the pediatric health care market. In the past, none of the players has been willing to yield to the others or create viable partnerships. There’s money at stake, and in any business venture, finances are an important consideration.

While most moms know someone whose child has been hospitalized, very few appreciate the way in which in-patient care is provided. We send over dinner and are grateful that our kids are healthy. Richmond has been unsuccessful in doing what’s best for children’s health care because “good enough” has always been acceptable. What we have accepted with three hospital systems can be summed up in the three “D’s.”

We dilute the expertise and resources. Doctors waste time driving to multiple hospitals to see in-patients when that time would certainly be better spent helping more children situated under one roof. The best pediatric EEG tech works in one hospital while the nationally recognized pediatric nurses work at another.

We duplicate services and waste valuable resources. Does a city our size really need three NICU’s for premature infants in the community and one at the university? If you count the empty incubators on any given day, you will see that the answer is a resounding no. Guess how much those incubators cost.

The saddest “D” is that we do without. One family had to leave five siblings with grandma and drive to Charlottesville for open heart surgery for their new baby because Richmond no longer has a pediatric cardiac surgeon. He left years ago to work at a real Children’s Hospital. Critically ill preemies are transferred from one NICU to another because not all are equally skilled in every live-saving innovative treatment available. We make due with the blood draw technician who lacks patience and skill with tiny veins. Really, it’s our children that are asked to do without.

Parents understand waiting. We wait nine months for the birth of a child. We can even extrapolate the three D’s into family life. If EVERY other city as big as Richmond has seen fit to build a hospital for its children, surely we must ask ourselves why we have not. Could we possibly have some inner wisdom that justifies this oversight? At best, we might argue that, “I just never knew!” When you know the need exists, what do you do?

Next time…Change4ANewChildren’sHospital. The penny jar campaign that is forming to spread the word. Check back soon to read more about what you can do to change the landscape of health care for Richmond’s children.

Gayle Schrier Smith, MD is a mother and pediatrician who hopes to practice medicine one day in Richmond, the city that cares enough about its children to build them a hospital (and where they’ll let her design the softest hospital jammies imaginable.) She writes the Doctor Download at Partners in Pediatrics.em>

(Read Part I)