There are numerous people in this country who do not believe in global warming. Some of them reject the science. Some believe that it might be happening, but it is not caused by human activity. A vast majority just do not bother to understand the issue and, because it does not affect them directly and/or they do not see how to change their lives to make a difference, they adapt whatever they feel in their gut*.
The same thing is true for healthcare. Any study that I can post here that talks about a volume/outcomes result will be denied by the Board majority and management. No study exists directly about Alameda Hospital. To do a comprehensive study would be difficult and expensive and likely inconclusive.
Last night at the Board meeting I proposed a natural experiment that would solve the first two problems (but not address the third). I proposed it in the context of the Board once again deciding to assess the more than 5.5 million dollars of tax on Alamedans to keep a hospital open that can only deliver mediocre healthcare outcomes.
I challenge the Board and management to undertake that experiment. Since 12/1/2010, the County has directed ambulances with all witnessed potential strokes with onset of symptoms less than 4 hours to facilities other than Alameda Hospital. We know those cases came from the 94501 or 94502 zip code. Prior to 12/1/2011, most suspected stroke victims from 94501 and 94502 were transported to Alameda Hospital. It would be possible with the help of Alameda County (which the Board has considerable pull with politically) to devise a study that compared outcomes for these patients for the six months prior to 12/1/2010 and the six months post 12/1/2010. I think this is an elegant design (probably since I thought of it myself). Unfortunately, even this relatively simple study would take a huge amount of time and face significant logistical hurdles. I rashly offered last night to do it, but that was a mistake. The study would have to be conducted by someone independent and someone who had more time/money.
Absent such a study, I will just have to go with something other than my gut to lead me to the conclusion that there is no circumstance that I can imagine where I would want to be treated for a potentially life-threatening condition at Alameda Hospital if advanced life support transport to another East Bay hospital was available.
*”That’s where the truth lies, right down here in the gut. Do you know you have more nerve endings in your gut than you have in your head? You can look it up. Now, I know some of you are going to say, “I did look it up, and that’s not true.” That’s ’cause you looked it up in a book. Next time, look it up in your gut. I did. My gut tells me that’s how our nervous system works. ” (Stephen Colbert)