Clinical Innovation in New York
City after Closure of St. Vincent Hospital
If I can
make it there, I'll make it anywhere,
It's up to you, New York, New York
Theme Song in New York, New York, Martin Scorcese Film
October 10, 2012 - The U.S. has a
resilient health care society
Witness, if you will, the proliferation of urgent care centers, retail
clinics, outpatient diagnostic and surgical centers, and concierge and
at New York City, where Greenwich Village inhabitants are doing well without St. Vincent Hospital, which closed two years ago.
the health system there been able to cope?
According to yesterday’s New York
Times, the system has been able to
do so by innovating in the outpatient arena.
In “New Style of Health Care Emerges to Fill Hospital’s Void,” reporter
Anemona Hartocollis observes,
building a hospital, one large chain, Continuum Health Partners, is establishing a
beachhead in Chelsea and the Village by connecting with outpatient clinics,
trying to dominate the market and create a feeder network for its hospitals in
other neighborhoods. It is joining forces not just with traditional clinics but
also with newer experiments like doctors working out of drugstores. A
competitor, NYU Langone
Medical Center, is expanding its physician practices downtown, and
like Continuum, it has hired dozens of stranded St. Vincent’s doctors. Several
walk-in “urgent care” centers have also rushed into the vacuum left by St.
Vincent’s in Lower Manhattan, hoping to show that they are more efficient and
consumer-friendly than a hospital-based system, but some have already begun to
form relationships with the hospitals.’
The reporter cites a 2009 RAND study of a Minnesota health
plan, where people received care for sore throats, infections, and urinary
tract infections in retail clinics with a 30% to 40% reduction in costs than in
doctors’ offices and urgicare centers, and 80% lower costs in in ERS.“
Executives at Continuum, which runs five
hospitals in New York City, “ she reports, “ say they expect their expansion into the community to form the foundation of
an accountable care organization.”
Greenwich Village residents
can now choose from a dozen clinics or medical practices that have been opened
or expanded by Continuum or are affiliated with it.
Continuum has also taken
over the former St. Vincent’s cancer center on 15th Street, and it has
established a clinic with a focus on H.I.V. patients on 17th Street, renovating
several floors and filling them with colorful pop art. Half of the doctors at
the clinic, called the Center for Comprehensive Care, were hired from the old
St. Vincent’s H.I.V. program.
Continuum has affiliated
with doctors practicing out of 13 Duane Reade drugstores in Manhattan and
Brooklyn, and has a contract to expand to 20 within the next year or so, and to
50 within four years.
“Everything is intensely competitive and
everyone is everywhere,” said Dr. Andrew W. Brotman, its senior vice president
and vice dean for clinical affairs and strategy.
Word of the new options
is trickling out, and some patients say they are not mourning St. Vincent’s.
Dr. Charles Carpati,
former chief of intensive care at St. Vincent’s, now at Lenox Hill Hospital,
said the community seemed to be coping without the old hospital.
“It’s been very hard to
show that people are dying because St. Vincent’s is no longer there,” Dr.
Tweet: In NYC,
retail clinics, urgicare centers, MDs in drug stores, and hospital-outpatient affiliations
fill the gap left by St. Vincent loss.
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