A far-reaching plan for reshaping medical care in Northern Virginia over the next five years drew heated criticism this week from area doctors and hospital personnel.
The protests were voiced at public hearing held by the Health Systems Agency of Northern Virginia (HSA), a private, nonprofit corporation created by the federal government last year. HSA is charged with studying and projecting area health care needs and making recommendations based on those projections.
At issue was an 837-page draft plan drawn up by the HSA and circulated among Northern Virginia officials and the public for comment. The hearing, held at the Thomas Jefferson Recreation Center, drew an estimated 300 persons, many of them physicians and hospital administrators. The draft plan was also to be the subject of two public hearings in Fairfax last night.
The HSA plan discusses a broad range of health care issues ranging from nutrition education to occupational safety.
Following the public hearings, the HSA board is scheduled to formulate a final plan which must be approved by the Department of Health, Education and Welfare before implementation.
At Monday's hearing, the testimony which was received most enthusiastically by the audience was given by Dr. Helen Hackman. Arlington County director of human resources. Hackman lauded much of the plan but cautioned that the cost of implementation would be "staggering" and is unrealistic in the wake of continuing reductions in social services induced by Arlington's three years of zero-based budgeting.
Hackman's statements on the plan's proposed guidelines for health planning - which she labelled "a giant step in the wrong direction" - drew thunderous applause. "A regulation is a document which delights the author and distresses the recipient," she said. "Regulators are written by people who don't understand the problem, to the distress of people who have to enforce them, and the ultimate detriment of the supposed beneficiaries.
"I support your aims . . . I don't expect to live long enough to see the HSA plan implemented. Like King Tut, I might include a copy in my tomb - minus the regulators," Hackman said.
Other HAS recommendations have aroused anger on the part of medical personnel who claim that the high utilization rates of hospital beds and services the plan advocates would result in severe overcrowding and inferior medical care. Typical of a number of statements made by physicians and administrators at Monday's hearing was one made by John McKinney, administrator of the National Orthopedic Hospital in Arlington who said, "The citizens of Northern Virginia are being bums rushed into a plan they'll have to live with the rest of their lives."
The entire HSA concept has also met with disfavor by some physicians. In a leaflet published by the Medical Society of Virginia called "HSA - Questions and Answers, -etc." The questions include, "Are HSA's a step toward federalized medicine?" The answer: "Many observers believe this is true.
Among the HSA's findings and recommendations which prompted testimony at all the hearings were the following:
a task force should be appointed to study how best to deal with the excessive number of hospital beds in Northern Viriginia:
efforts should be made to develop a hospice for dying patients and their families.
there is a shortage of halfway houses and other intermediate treatment facilities for psychiatric patients in Northern Virginia.
because it has less then 2,000 births per year and is within 30 minutes driving time to another hospital, the obstetric unit at Arlington Hospital should be studied by a task force for possible closure.
Last Saturday the Arlington County Board unanumously passed a resolution asking the HSA not to consider closing the hospital's maternity ward for at least one to two years.
A number of speakers criticized the sheer breadth of HSA's plan and questioned the competency of the board, composed largely of consumers, to develop a comprehensive plan in less than a year. One hospital administrator predicted that the HSA plan would result in insolvency and bankruptcy if adopted in its present form.
J. Edward Sweet, Jr., administrator of the Alexandria Hospital, echoed the statements of several physicians and administrators critical of the scope of the plan when he said, "You have tried to take a position on everything - and I do mean everything."
A contingent of approximately 10 physicians and administrators told the group that closing the maternity ward at Arlington Hospital would be disasterous for Arlington growing population of low-income and medically indigent women.
Dr. David Reese, chief of the hospital's pediatric department noted that Arlington is one of only two hospitals in Northern Virginia with full university affiliation. Closing the obstetrics unit. Reese said, would likely have a domino effect on the related gynecology and pediatrics services and would damage Arlington's affiliaton's as a teaching hospital for Georgetown University.