Too many hospitals

From Robert Whitcomb's "Digital Diary,'' in

Care New England’s decision to close Memorial Hospital, in Pawtucket, or at least its inpatient services and emergency room, didn't surprise me at all. The fact is that Memorial’s days as a full-scale community hospital have long been numbered.

Our region has too many hospitals in a time when highly effective medications for such chronic ailments as heart disease, as well as proliferating outpatient facilities, such as comprehensive  and specialty physician group practices, urgent-care centers, drugstore clinics and free-standing emergency departments, treat many of the ills that used to be treated only within hospitals.  Just consider the number of surgeries now done outside hospitals, and that patients are discharged from hospitals after surgery there much faster these days. What might have kept them in a hospital for a week or two a couple of decades ago might now only keep them there for a couple of days.

And for the really serious and/or complicated stuff, patients can go to Rhode Island Hospital or the Miriam Hospital (the latter very close to Memorial), both in Providence, or to a hospital in the world-renowned health-care complex in Greater Boston (of which the Providence area is gradually becoming a part).

Only a small percentage of Memorial’s almost 300 beds are occupied and the place’s operating losses continue to swell.

So what will become of the facility? Probably much outpatient treatment and testing will continue in parts of the hospital buildings; after all, lots of physicians’ offices and very expensive equipment are there. (I go to see my cardiologist at Memorial every few months.) The rest of the structures might be turned into apartments, condos, offices, coffee shops, bars and so on – rather like a mill conversion.

The controversy about Memorial is really more about the threat to the hundreds of jobs at the hospital and the associated politics than about health care. But given the aging of the population, among other factors, the need for physicians, nurses, nurse practitioners, health-care aides and others in the sector will only grow; most of the laid-off folks at Memorial should fairly swiftly find new positions. But many will find leaving the hospital wrenching even as they find jobs elsewhere in the region that might be better for them in the long run. It’s a community.

Of course, politicians will denounce the closing even as they fail to come up with plausible arguments for keeping this old community hospital open in a time of revolutionary change (and confusion) in health care. And it’s been a very long time since Pawtucket was the sort of thriving factory town that could easily support such institutions as hospitals.

Now the city ever more desperately seeks the state’s help to finance a stadium for the Pawtucket Red Sox, although most Rhode Islanders oppose such help, according to a poll done for GoLocal by Socialsphere -- founded by John Della Volpe, the director of polling at the Kennedy School’s Institute of Politics at Harvard.

Far more promising is the coming Pawtucket/Central Falls train station. This facility will, among other benefits,  help those cities become Boston suburbs for those who can’t afford the very steep housing costs in and around “The Hub’’ and maybe get some back-office work from  Greater Boston companies in mills and other old buildings that have so far escaped the arsonists. Maybe some will live in what is now Memorial Hospital.