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The Ripple Effect

November 13, 2008
by daphne
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I read the daily news with dread. It’s full of hospital closings and layoffs—and in my state anyway, a new round of Medicaid cuts announced today is making things look pretty grim.

While we often think about how this affects patient care, there’s another tragedy caused by hospital closures: the loss of jobs to that sector of the population that has the hardest time finding them—the service workers. The people who fill the ranks of environmental services, nutrition, the clerks, secretaries, the people taking care of their families the best they can, the people for whom a hospital job means they can pay the rent and, and represents a step up from the welfare rolls. Our hospitals, especially in poor, inner-city or rural neighborhoods, are the biggest employers around—and are often the only game in town when it comes to work. For much of the staff in these hospitals, this is their best shot at a decent, living wage—and a source of dignity. “I work at the hospital,” I used to hear people in the South Bronx say, with pride.

What is going to happen to all those people when the hospital closes? And then, when they no longer come to work every day, what is going to happen to the guy who owns the deli across the street where everybody buys lunch? The florist down the block? And the little old lady selling two-dollar bracelets on the corner? I see communities slowly imploding.

Those of us in the business of running hospitals need to remember we have a responsibility not only to patient care, but to these people as well. We need to do whatever we can to keep our hospitals open. And to keep these people in their jobs.

Our president elect has repeatedly mentioned HIT as a solution for some of what ails healthcare in this country. I sure hope he means it, and he can't get started soon enough. I say that for me, and for my friends in the South Bronx.



We all have seen other economic downturns - and for the most part healthcare has been somewhat insolated from the massive lay-offs and company closings when compared to other sectors. This environment is clearly a different animal.
Hospitals in local communities have always been a safe-haven for the sick and injured. When you see closings take place you have to feel that part of the community's' fabric has vanished forever. It's sad - but true.
I think Barack Obama has inherited a real mess and he will be challenged to make massive changes as the problems with this economy are simply monumental, and impossible to fix overnight.
I do hope there is a HCIT push to help improve some of the technology challenges we face in our sector. Like I said before, in previous economic downturns, healthcare has usually been somewhat insolated - but apparently not in this one...

Hi Julie, I am more concerned here about an entire hospital closing and what that can do to a community, rather than the lower sector losing their jobs before the C-suite. I have know many C-suite execs who cared deeply for ALL the staff members in their hospitals, and take the responsibility to their community very seriously. They have attended birthdays and retirements in the kitchens and basements (though to be fair, I've known other c-suite execs who were 20 miles high and never touched the ground) I don't believe the blame is always on the C-suite, it's more the general state of this economy, and the mess healthcare is in today.

In observing your comments, I was touched by your thoughtful words of individuals who may or will lose their job. Why in America do job cuts start at the bottom when really consideration should be given to those with the biggest salaries, such as the C-suite.

It makes me sick to see anyone lose their job, especially those who work in Environmental Services or nutrition, but do you really think that these individuals are ever given priority?

If you take a look around, many hospital executives have bloated ego's and would never remember anyone's name unless they are servicing their bottom line.

In a comment response to Kate's post, "Obama wins --- now what?" I posted a link from the WSJ.  The article had an attached video.  In the video shown below, Susan Nowakowski makes a point that builds on your points, Julie, Daphne and Tim. 

Since Obama's plans call for broader healthcare coverage and access, we're going to have increased labor demand, concurrent with the current trend of decreased labor capacity (a shortage, at least of nurses, pharmacists and physicians).   Truly a double whammy, increased labor demand on top of decreased labor supply.