Santa Clara Valley Medical Center's Reorganization
By Hilbert Morales
At a national level, President Obama is stumping for Congress to pass a Comprehensive Health Care Reform bill by March 18, 2010. If no reform now, when? These same questions are facing the Board of Supervisors and the County Executive, Dr. Jeff Smith, who began reorganizing efforts by assuming control of the Alcohol and Drug Programs. Recently two SCVMC top management officials left and the sudden termination of a chaplaincy contract with the Catholic Diocese of San Jose surfaced.
The local community, especially its Hispanic component, needs to become very concerned about what is being planned for the future of SCVMC. The easiest thing to resolve is the chaplaincy issue. In keeping with the separation of church and state, a coordinating office of religious affairs needs to be established which coordinates faith services for patients, their families, religious officiates and the medical care professionals. No recognized religion can be excluded from such services.
The more difficult issue is how to retain an effective medical care system that has served the residents of the County of Santa Clara for many years. SCVMC began as a tuberculosis treatment center; evolved into a 'county hospital,' followed by a community hospital, and then was transformed into one of the best medical tertiary care systems in the nation operated by a county jurisdiction.
The most important part of SCVMC is not very visible to those who focus on the central medical facilities located at Bascom Avenue and Moorpark Street. The Health and Hospital System operates a number of community clinics that provide local access to residents, providing excellent general medical care in their local community. These local clinics are very effective in providing the primary medical care that a community requires. Diseases that require more differential diagnostic knowledge and the use of high tech medical technology (Cat-scans; MRIs, radiology and clinical chemistry testing, etc.) are provided those services at the centrally located SCVMC. Here the patient is often provided the same differential diagnostic expertise now available at Stanford Medical Center simply because many Stanford Medical School training programs are at SCVMC. Simply stated, SCVMC is a teaching hospital where many medical technology, nursing and medical students obtain their practical training and experiences.
It is very superficial to just think about this medical care system as a 'hospital'. What has to be taken into account is the reality that with increasing medical knowledge and its applied technology, the ability of health care professionals to effectively treat patients while keeping them ambulatory has increased significantly. Therefore, it is essential that the plans for SCVMC as well the medical facility in downtown San Jose be permitted to develop and be implemented while dealing with the budgetary issues of the Health and Hospital Systems which incorporate mental health care.
While the major focus today may be balancing the budget of the County of Santa Clara, which is projected at $250 million, it would be wise to be very careful about major changes in a health care system, which works so effectively that every resident is seen at least once every four years. What is possible immediately is the necessary search for waste caused by the inefficiencies present, some of which are a direct result of ineffective and inefficient personnel management practices, which protect certain union employees by slowing down performance review procedures. A variety of agreements with suppliers and medical professional groups need to be included in a performance effectiveness evaluation and assessment.
This Health and Hospital System, County of Santa Clara, does need to change in ways that permit the local community to continue to directly support it. In closing, let the major changes be subject to review by interested members of the public. The Hispanic community, which is the largest ethnic group that has depended on this facility for decades, must find a way to be involved, supportive, engaged, and become a full fledged stakeholder actively monitoring what is being planned by others who have their own agenda and goals. A very important issue is to have continued access to health care. The community must insist that the 'open door policy' at SCVMC's Emergency Room be continued. It is the only ER operation with an open door policy in the entire San Francisco Bay Area.
It is very important that local residents tell their elected officials, especially those in Congress, that any new Comprehensive Health Care Policy must fairly compensate SCVMC on a performance basis. The Health and Hospital Systems, County of Santa Clara, earns and deserves the support needed while making changes to remain contemporary and current to permit delivery of a mosaic of health care services to this community.�