No Trauma Centers on the South Side?

In late August, Damian Turner an 18 year old resident of Woodlawn was killed by a stray bullet. The corner where Damian was shot (61st street and Cottage Grove) is one I know well. As a  graduate student at the University of Chicago I often drive by that intersection while looking for a parking spot on the mornings before class.

The Grov Parc apartment complex where Damian lived is only four blocks (perhaps a 15 second drive) from the University of Chicago Hospital. However, Damian could not be rushed to the University of Chicago Hospital because it does not have an adult trauma unit. For this reason, Damian was taken to the nearest adult trauma unit at Northwestern Hospital. The trip took about 10 minutes.

Did those extra ten minutes cost Damian his life?

We’ll never know, but it is an injustice that we are left  wondering this question.

Trauma units are designed to treat emergencies caused by shootings, stabbings, and other acts of violence. Currently, that are no trauma units on the South Side of Chicago–despite the fact that incidences of violence are alarmingly high in this region. Trauma victims must be transported to either Northwestern Hospital in the Loop, or to a hospital in the Western Suburbs.

This morning at 11 am, residents of the Woodlawn community and members of the South Side organizing group STOP gathered for the second time outside the University of Chicago Hospital to voice their demand that a new adult trauma unit be built.

Although the University Hospital used to have a trauma unit– that program was discontinued. Hospital officials remarked that the program was simply too expensive to run, and that the hospital was swamped with trauma victims from the entire South Side of the city. (It is worth noting here the Hospital’s concerns about costs. Victims of violence are disproportionately young, minority males. These patients are more likely to be Medicaid patients or to be uninsured).

Last fall, I worked as a social work intern at the University of Chicago Hospital. I can say with confidence that the hospital operates a number of costly and impressive programs. There is a first class treatment center for patients with cystic fibrosis. The hospital is the only in the city to perform lung transplants. One of the doctors in the transplant unit is qualified to do bloodless transplant surgery– one of only a handful of doctors to possess this qualification in the entire country. While I was working at the University Hospital I noted that it drew patients (especially in the transplant and oncology units) from all over the state and all over the Midwest.

Needless to say, the hospital makes choices about what kind of research it will conduct, which diseases it will treat, and how it will spend its money. A recent article in the New York Times reports that the University of Chicago Hospital is in the process of building a new 700 million dollar pavilion.

All of this invokes the question–who do hospitals have a responsibility to serve? Do hospitals have a responsibility to serve the communities where they are situated?  Or, do hospitals choose which types of diseases they will provide treatment for–and expect that patients with these conditions (regardless of where they are located) will come seek their services out of necessity?  Clearly, the University of Chicago Hospital has made a choice to provide certain kinds of treatments (and to privilege certain populations) over others.

Undoubtedly, no hospital can specialize in every type of care. However, I worry that hospitals will frequently avoid specializing in the treatment of conditions that disproportionately affect the poor and uninsured. Trauma units are just one example.

Is equal access to healthcare a human right in America? If so, we need to find a way incentivize (or require) hospitals to provide services for the poor. The way things are, hospitals (such as U of C) can strategically choose not to offer services that are likely to be used by high number of Medicaid or uninsured patients.

Note: This post draws heavily from the following NYT article for factual information: http://www.nytimes.com/2010/10/03/us/03cnchospitals.html?pagewanted=1&_r=1

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