Even though I suspect that the decision has already been made, I would like to weigh on the possible closure of the Lake Placid emergency room. Other than being a member of the general public, I have no particular ulterior motive in the fight. I think that the emergency room should remain open. I think it's a valuable resource for many people in the area that shouldn't be squandered. I realize that most of the salient points, pro and con, have already been raised, such as such as time in transit, cost of services, etc.
What hasn't been mentioned is the fact that people in Lake Placid, especially those of a certain age, have spent their lives watching medical services gradually being shifted to Saranac Lake. They have seen their hospital go from a decent, if modest, one to one with limited and specialized, if needed and excellent, services over the course of the years, all in the name of efficiency and cost savings. The maternity wing closed in the 1970s. The majority of doctors have their offices in or near the Saranac Lake hospital. If you need blood work, you are encouraged to use the facility in Saranac Lake. All of this has placed a burden, in time and money, on people in the surrounding towns, especially those with limited access to non emergency transportation. Over the course of the years, the shift of services has also driven down the number of visits credited to the Lake Placid hospital, thus reinforcing the argument for further consolidation of services. Hence the general argument of, "Nobody goes to the Lake Placid hospital except for emergencies."
To live and work in the Adirondacks, which most of us have chosen to do and rather enjoy, you have to accept certain inconveniences, but timely access to emergency care should not be one of them. In American medicine, emergency rooms are important way stations for the stabilization of patients. And what about the patients who need specialized care in those first few minutes of a medical emergency? For the doctor waiting at the hospital, those extra 15 or 20 minutes seem no great burden, but to the person in the ambulance, that might seem like an eternity. (And what of those that live farther away? How long would that ambulance ride feel like?) Several of the doctors speaking for the closure seem to think those extra moments won't make a difference for most cases, but it is inevitable that for someone, those minutes will make all the difference.
While, in a perfect world, everyone in distress would call an ambulance, the last time I looked, the world was far from perfect. A few people, because of cost and a strong streak of stubbornness, might decide to walk to the nearest emergency room. I can think of a case or two in which someone bypassed the ambulance and walked there. Luckily for that person, the injury wasn't life-threatening, nor the distance that great.
Even though I couldn't find any statistics on local emergency room visits, I suspect that on most nights in most area emergency rooms, it is extremely slow, particularly in the wee, small hours of the night. That is just a hunch based on the sense of the population figures of the area.
A few side points: Adirondack Medical Center is a good hospital and important to the life and economy of the area, but it is not a "state-of-the-art" one, even if, with the speed of the changes in medicine, that were even possible. But then again, I'm no fan of over-reliance on gee-whiz, high-priced medical machines. I realize that MRIs, CT scans and all the other high-tech machines have saved countless lives, but I prefer a doctor who thinks on his or her feet, especially in an emergency situation.
Whatever happens to the emergency room in Lake Placid, I'm glad to see that people in Lake Placid and the surrounding areas who are affected by this decision are passionate about being heard about the proposed change.
I do have one slightly snarky aside: Perhaps the head of Adirondack Health might think about enrolling some of her doctors in a public relations class before letting them loose in the media and in public hearings. One or two of her spokespeople, official or not, seem to be aghast that anyone should question their or the hospital's motives. Isn't skepticism a healthy attitude to have in a democratic society? Shouldn't people be upset that their hospital is on the chopping block?
Everyone is aware that we live in a capitalistic society and that most decisions affecting health care in the entire world are determined by the costs and not what is ideal. In addition, most people up here are well aware that their lives are governed by hard economic choices and that those choices are made by others. So there is no need to lecture people up here on what a tough economy looks and feels like; they know all too well. I suppose that the needs of the many will outweigh the needs of the few and, especially, the needs of the one. But I hope that the powers that be remember that they might be leaving those few behind, quite possibly, to die. I'm glad I won't be the one making the decision.
I think the angst that everyone in Lake Placid and the other communities is feeling is the disquiet with the fact that no one is happy that their lives are viewed merely as figures on a tally sheet. Nor should they be happy with that thought or tolerate it, even though it's probably truer than we like to think.
Alma L. Southmayd lives in Lake Placid.