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Re "Is This a Hospital or a Hotel?," by Elisabeth Rosenthal (news analysis, Sunday Review, Sept. 22):
I am a registered nurse, and over the last few years I have noted the same trend that Dr. Rosenthal writes about.
While I agree that several of the changes have a solid basis in sound medical and nursing practice — private rooms can help prevent the spread of antibiotic-resistant infections, and privacy helps a patient get better rest — other changes are not based in medicine but rather seem intended to mask the fact that a person is in the hospital.
That is not necessarily a bad thing, because it can improve patients' perception of the quality of care they receive. What worries me as a nurse is that it can create unreasonable expectations regarding the healing process.
By providing a hotel-like environment, is it possible that we also encourage people to conflate quality health care with luxurious surroundings, and set ourselves up for a perceived failure to provide quality health care when a patient fails to recover fully?
CAROLYN CONLEY
Berwyn, Pa., Sept. 22, 2013
To the Editor:
I was glad to see someone finally recognize the overbuilding that has gone on in the hospital infrastructure in this country with nothing more than pleasing aesthetics as the hospital administrator's guideline.
As a doctor I have watched community hospitals in my area spend millions on projects that have little to do with patient care. They have done this under the auspices of self-selected boards of trustees pushing aside any meaningful criticism. They have sought little public input throughout the process.
The boom has passed. Valuable resources have been squandered. My advice is to try to stay ahead of this issue. Start looking at the administrative scenarios that lead to such rash spending. Start looking at the chief executives' and other administrators' compensation at these "community" hospitals.
MICHAEL SOUTHWORTH
Madbury, N.H., Sept. 23, 2013
The writer is a vascular surgeon.
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