The Big Public Hosptial Part 4, or Persevering with Patience

November 16, 2006 at 2:22 pm (Michael's Posts)

So this week, I have been thinking a lot about sustainability.
I think Alex Coria defined it well (in terms of what I mean by the [buzz]word) in her comment on the “On medicine abroad” post by AE Beacon:
I think in a health context, sustainable means locally sustainable without depending on non-locally produced or trade-derived resources. So basically, if all the charitable giving was taken away, being able to sustain a comparable level of health.
I wonder if my Big Public Hospital is sustainable.
If the County Board changes spending, it’s not. The Board has decided to shut down a number of the satellite clinics associated with the Hospital because of the extreme strain on funds they are experiencing. Just as in one of my past posts, I have speculated on the unsustainability of my particular program, the hospital itself is not, either. We are surviving on the good will of the County and the (possibly unconscious) good will of the taxpayers.
We are also surviving with limited resources and dense, often seemingly nonsensical, bureaucracy. Projects move slowly because the people running them are also running a number of other big things or are pulled in too many directions to give their full attention to things. It is not for lack of good will that the doctors I work with were not able to get things started for over a month. It’s just the reality that there were too many other things going on. The human resources are stretched thin.
I think this may be the case in other, non-resource-poor situations as well, but it may not be.
I did research at a private medical center in Rhode Island and whenever I needed something, I got it. Here and there, there were days that I couldn’t reach the doctor I was working with because she was very busy but by and large, I got the support from her that I needed. We sometimes had to wait a day or two to get in touch with some of the doctors at other hospitals, but never as long as at the Big Public Hospital.
When resources are scarce, patience and perseverance are the words of the day. Every day. The work we do is good. Very good. It is also something that moves slowly. In the time of fast internet and immediate gratification, this can be extremely frustrating.
I don’t have a very good idea about how quickly projects move in areas of resource wealth, but I can definitely say that where they are lacking, it’s often slower than I’d like.
Any reflections on the progress that anyone else feels they are making? And please be sure to comment on your workplace’s resource levels.


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