BACK TO HEALTH CARE..

I had written a log post on Hospital ER including how it impacted on "coasts" as well as material on the Neighbourhood Health Center but POOF in went into cyberspace and I have not been able to locate it so I will have to reconstruct it.

The original intent for the hospital emergency room was that it should be the place where initial urgent treatment was rendered prior to hospitalization. It also served as a triage point. The term emergency meant that treatment was rendered when time was essential. The ER was never indented to be a treatment center for "routine illness" in the absence of a personal physician.

Over the years that concept changed and patients with urgent need of care went there after the physician's office was closed. For patients that had no doctor or could not afford one the hospitals operated clinics in the various disciplines on weekdays. They were staffed without compensation as part of their staff and community obligation by doctors who had staff privileges, usually the youngest or most recent staff members. Supervision was by one of the Attending Physicians. The patients were either treated without charge or paid a small fee depending on their economic circumstances. All monies were collected and kept by the Hospital.

This agreeable solution to render care to those who could not afford a private doctor was destroyed as an unconcievable result of the Federal Government's action in providing payment through Medicaid and Medicare when faced with the greed of hospital administration supported by compliant paper Trustees.

With the introduction of Medicaid the patients visit was paid for. The hospital received money for the use of its facility and for the medical services. They refused to share that with the physicians who were providing the service the portion delegated for the physician's services.

At the time hospitals knowing that there was payment involved encouraged the use of the ER as a walk in treatment center. To solve the issue of paying the doctors staffing the ER they hired or franchised the medical services to groups of doctors willing to work set hours and having no responsibility to a patient after their "shift" was over.

They also eliminated the physicians who felt that they should be paid for their services from the clinics. But ultimately those clinics became too costly to operated and the institution was becoming exposed to malpractice risks.

One solution in Plainfield was the Neighborhood Health Center. This was originally an independent charitable organization functioning out of a building behind a group of early 20th Century tenements on West 4th Street bear Plainfield Avenue,. It may have had a relationship with the Moorland Branch YMCA, a segregated unit from the main "Y".

As more Federal and State funding became available the hospital found it advantageous to develop a partnership with NHC and transfer the hospital clinics to that facility and ultimately to the present day building on Myrtle Ave off Rock. Although separate from Muhlenberg there was some overlapping of the Boards. The NHC's medical staff were given privileges in their respective specialties for inpatient treatment in the Hospital. For obstetrical patients the hospital wa sreadily available. Most of the medical staff salaries were funded by Federal Grants.

The NHC concept was for it was to be the equivalent of a diversified group practice, like the Summit Medical Group. There was no original intent that it would be a 24 hour walk-in-box.

I have little knowledge if it is functioning 24/7 since the Hospital closed or if the MRC ER is still supposed to be acting as an urgent care facility. Nor do I think anyone knows how long Solaris intends to so operate.