You Want Your Children To Be Independent. Their Children’s Hospital Must Be, Too

It’s no secret that hospital systems in Richmond, Virginia have very different cultures.  Vastly different.  They function independently, compete voraciously and excel in different ways.  But parents understand diversity is part of life.  Children understand the phenomenon, too.  Toddlers are aware of the Tiggers and the Eeyors in play group.  Elementary School teaches that the jocks and the nerds thrive in different cultures.  In the Sandbox of our children’s world, we teach them that sharing is the gold standard and that hitting and unkind words are wrong.  As a pediatrician and a mother, I know that we change the world by what we teach our children.  We want our kids to grow into consensus builders and collaborators, not into bullies or dictators.

The lessons of cultural sensitivity are many.  It’s time for those hoping to have a real children’s hospital to be thinking about how we can overcome the very different cultures that exist among our hospital systems.  With an INDEPENDENT children’s hospital, we can overcome the challenges created by trying to merge adult-hospital cultures.  If we have learned anything from history, we know that it has not been possible to bridge the distance between the culture of the VCU Department of Pediatrics and the community hospital efforts to provide for children’s healthcare.  Brilliant administrators, compassionate physicians, and wise mediators have tried and failed, over and over again to blend those very different hospital cultures.  At one time in the not-too-distant-past, BonSecours and VCU were meeting often to build consensus and a team to have this hospital.  I liked to think of it as the Team of Rivals.  There was a golden carrot of the largest philanthropic gift in the HISTORY OF CHILDREN’S HOSPITALS (yes, I’m shouting…) dangling right there in front of these PowerPeople.  The goal was to have one collaborative children’s hospital with many leadership opportunities for all the hospital systems. Sharing power and risk seemed a logical plan, but the very different cultures got tired of compromise.  They lost the will to move beyond differences to create solutions.  #EpicFail is what the kids would say.  What will happen without collaboration among the three hospital systems and their divergent cultures?  I suppose it’s anybody’s guess, but I have mine.

VCU may proceed alone and build their own free-standing facility for CHoR.  In truth, if they don’t do something, they will continue to struggle to recruit good medical students and pediatric subspecialist faculty.  The faculty they have, many of whom are tired and over-worked, will continue to look elsewhere for career opportunities.  In spite of all the potential at VCU Medical Center, the department of pediatrics struggles with its image.  Its culture is one of research and expert subspecialists, but also of long waiting times, notoriously poor communication, and the parking is awful.

BonSecours may build a Children’s Hospital, too.  I’m guessing they would likely partner with UVA for the academic and teaching mission critical for a children’s hospital to be successful.  Their hospitals already provide a third of the city’s pediatric inpatient care, and just about every pediatric subspecialist is available to the patients already.  Lots of community pediatricians have hospital privileges in their Open Staff Model, and most are familiar with the culture.  BonsSecours pays a lot of attention to their image, but they lack the reputation of an academic medical institution even though the parking’s better.

If I am right, and the scenarios above unfold, which Children’s Hospital will we choose? Your child needs expert services, and I am the doctor.  We will have to choose between the two hospitals for children.  I want ONE hospital, independent of the foolishness and politics.

Independent means we are starting over; we are creating something new… beginning where innovation usually starts.  Independent means every aspect of building greatness is considered, justified, and the result of collaboration.  With the best parts of three hospital cultures sifted and mined, INDEPENDENT is about forming forming one hospital from what’s worth keeping…  one culture that kids understand.  Independent means we are not building a spin-off service line for children from what we already have using administrative strategies that work for sick adults. Independent means we are building a new culture of care to speak the language of children.  We are designing the hospital that leapfrogs past CHOP or Cincinnati Children’s with ideas and services that don’t even exist yet in those prestigious places.  Independent creates the culture of children.  INDEPENDENT means that we must support our adult hospital systems so they can do the right thing for the children.

Children grow up.  They move out of our homes, and they go on to live amazing lives…most filled with greatness.  It’s time for VCU to let go of their ‘child’.  CHoR is a pretend children’s hospital, and she is ready to grow up.  Independent is what you become when you grow up, and an independent hospital is the only place for the culture of a true children’s hospital to flourish.  Today is a new day … I read that on a billboard once.

Before all of my children grow up… please give them the culture that lives inside a true, independent children’s hospital.  It’ll be so amazing, it can’t fail

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