Random thoughts on community vs. teaching hospitals

Volunteering with MOC has brought me to different hospitals in New York City. These short surveys obviously do not tell me much about the hospitals themselves, but they do give me a sense of the working environment I would like to have someday as a physician. When I first started volunteering I went to a very well-funded hospital, where the grateful gifts of its many well-to-do former patients were displayed everywhere on the floor and the walls. Some floors were carpeted entirely, and many rooms were labeled with smooth memorial plaques in remembrance of certain individuals who once lived there. Walking around in semi-casual outfit, passing through visitors in suits with leather briefcases made me feel out of place, perhaps even under-dressed to bring my gift to the patients. This false impression fell apart quickly, of course, as I saw the faces of those who found some comfort in music. Those who are hurting in body are fundamentally the same everywhere (with some major differences that will not be further discussed here).

This week I went to a small community hospital that serves a neighborhood with big and diverse immigrant populations. As the car pulled in front of the hospital, I did not even realize that I have arrived because the six-story brick was so small to someone who is accustomed to gigantic teaching hospitals. There is a total of one elevator in the hospital, and when I commented to my guide on its small size, she laughed and said, "But somehow they manage to fit a stretcher in here." Despite its unimpressive appearance, there was something among the hospital staff that I have never seen elsewhere. They seemed to enjoy their job much more, and there was a genuine sense of comraderie among them. Furthermore, they seemed to have a closer relationship with their patients than those in bigger hospitals. Several nurses made sure that I visited their patients and even stayed to listen with them. There are, of course, several reasons one can imagine that contribute to this, a major one being the discrepancy in work load and perceived pressure. However, I can't help wondering whether one would actually receive better care in a small community hospital like this than in a rich teaching hospital, where the staff is overworked and overwhelmed by administration politics on the side. Something to think about.