Editorial: Doctor’s orders at Martha Eliot

March 1, 2013
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The opaque, top-down decision-making at Martha Eliot Health Center that is kicking out 5,000 adult patients and putting future service details up in the air has left the neighborhood speculating about what is really going on.

The Gazette was among those left guessing, and last month, we guessed wrong in this space when we speculated that Brigham and Women’s Hospital (BWH) was playing a leading role in the decision.

In fact, Brigham and Women’s was blindsided by Boston Children’s Hospital (BCH) like everyone else. We apologize to Brigham and Women’s.

We are happy that the neighborhood now has more information and has to guess less. And we regret that BWH, a powerful partner in JP’s community health for decades, did not have a chance to continue that role at Martha Eliot.

BCH made this decision, unilaterally and deliberately without local input, based on its fair perception of how upcoming health care reforms and standards will impact it. It is clear that this is a great decision for BCH.

It is not clear that this is a great decision for Bromley-Heath, Jackson Square and Jamaica Plain. BCH performed no study on the local health care impact or needs beyond seeing if other doctors somewhere else had room for the patients it wanted to get rid of. It also did not tell anyone about such changes as laying off the director of the center’s active community programs, which continue for now.

BCH says it will seek some sort of local input, in ways yet to be defined, in its review of what sort of health care and services will remain at Martha Eliot. This could all turn out very well. The concern about Martha Eliot is rooted in its high-quality care and the fact that BCH is literally one of the world’s great hospitals. Martha Eliot could be reborn with sharper, better children’s care.

But that only happens by listening to the community it serves. Right now, BCH is giving old-fashioned doctor’s orders. But it is making diagnoses and conducting surgery on JP without doing a full exam and lab work. In the modern world, we know that the best medicine is done in cooperation with an informed, active patient.

JP should not wait around for BCH to decide the future of Martha Eliot Health Center. It should organize to set the agenda, lead the discussion, and help the center renew itself not only as a doctor’s office, but also as a community partner.