The District's health delivery system has been studied repeatedly, Dr. Jesse Barber, president of the D.C. Coalition of Health Advocates, said last week, and the conclusions are always the same: medical services are not evenly distributed among the haves and have-nots.
Barber and representatives of about 20 District neighborhood and civic associations met Saturday to discuss the accessibility of medical care in the city. The meeting was sponsored by the Medical Society of the District of Columbia and attended by about 100 people. It was coordinated by Dr. Roselyn Epps, former acting commissioner of public health.
In a succession of brief speeches, the civic leaders called for improved medical services for Southeast residents, better mental health services, more long-term care facilities for the elderly, better tuberculosis control, counseling for families of cancer patients, shelter for abused and homeless women, and more attention to the health needs of adolescents -- especially drug users.
One speaker noted that D.C. General Hospital, one of the busiest hospitals in the city, did not have a CAT scanner, a sophisticated X-ray type machine, although many other hospitals in the city do have them. Therefore, about 800 patients had to be transported to other hospitals last year for scans.
Barber said there are fewer private physicians practicing in Southeast than elsewhere but, even so, their services are underused because many residents in that part of the city are accustomed to going to an emergency room instead of to a doctor when they get sick.
"This community has been terribly apathetic," said Dr. Paul Cornely, chairman of the conference. He said residents do not protest loudly enough about inadequacies in the city government. "I can't understand how we can allow this city to be without a health commissioner for this long," he added. "We need to confront the city, confront Congress." The post of health commissioner has been vacant for a year.
While Cornely blamed citizen apathy for the city's failure to improve services, Mayor Marion Barry, who stopped by briefly, said that the tightening city budget was a major obstacle in improving health services.
Ruth Richardson, representative from Advisory Neighborhood Commission 8B, said poor planning was a problem in the Department of Human Services. Richardson cited the closing of Glenn Dale Hospital in Maryland last year, the District-operated hospital for the chronically ill, and complained that the patients were "dumped" on the already understaffed D.C. Village.
However, Paul Lavigne, head of the city's Long Term Care Administration, explained that of the 290 Glenn Dale patients, only about 90 went to D.C. Village and some of the nursing staff went with them.
Frank Bolden, representing the Federation of Civic Associations, suggested that a separate health department independent of the social services administration could make more efficient use of its funds and resources. This idea has been widely supported by medical society members.
Although no new issues were raised at the meeting, Epps said she was pleased that the Southeast and Northeast areas were well represented. Richardson said that most of the important health issues were discussed, and added, "Now I want to see where the action is."