At the center of Knox County's
allopathic health care system is the county hospital, Knox Community Hospital (KCH). A large percentage of the
county population passes through KCH every year. According to Robert Polahar, CEO of KCH, 20,000 people are admitted
to the hospital every year for inpatient care. The emergency room sees an average of 22,000. An additional 60,000
people utilize KCH outpatient services yearly, for a total yearly patient population that is "getting close
to the hundred thousand mark." The leading reasons for hospitalization in Knox County include pulmonary or
lung diseases, followed closely by cardiac disease. There are 70 physicians, who can be divided between 20 specialities,
on the hospital staff. Procedures which cannot be done in Knox County at this point in time include neurosurgical
procedures to treat diseases or injuries to the head, brain, and spine; cardiac surgery; some cardiac diagnostic
procedures; some types of cancer treatment; vascular surgery; or high-risk pregnancy care. For such services, KCH
patients are generally referred to facilities in Columbus. In all other ways, KCH has both the personnel and facilities
necessary to treat the medical problems of Knox County.
Very few people in Knox County have no access to health insurance. Approximately 64% of Knox County residents are covered by Medicare, another 8% by Medicaid, while the rest utilize other commercial kinds of health care. HMO penetration in the county is currently at about 3%. Only between 1-3% of Knox County residents possess no forms of health insurance. These economic facts should theoretically translate into good access to health care for the average resident of Knox County.
Knox Community Hospital does not at this time actively support any holistic practices. Massage therapists are employed by the hospital, but only under the realm of physical therapy. Polahar gave a number of different reasons for this. The primary reason given was related to the allopathic medical staff:
It would have to be endorsed by our medical staff as a whole. And you have to understand that with the organizational structure and how our accreditation and licensing fits in, that the board of trustees holds the hospital in trust for the community because it's a not for profit corporation. I report directly to the board of trustees and over here there's this group of people with a dotted line to the hospital and a dotted line to the board of trustees and that is the medical staff. And the board of trustees delegated to the medical staff the authority and the responsibility of overseeing the quality of care in the hospital. And along with that, responsibility is the ability to credential practitioners coming in to work at the hospital. So your decision making on what it and what isn't medicine–good medicine, bad medicine, sideways medicine, whatever–is held in this little circle over here on the organizational chart that makes that determination.
The medical treatment provided by the hospital, then, is supervised by the medical staff, a "conservative
group" who are unlikely to support staff privileges for or to make referrals to
holistic practitioners. The beliefs of the medical staff about what medicine should be determine the practice of
medicine that goes on at KCH.
The other reason given by Polahar for the lack of holistic practices supported by KCH is the focus of the hospital itself. KCH is designed to provide " not health care, but sick care." This statement is a telling one about the relationships of hospital patients with hospital physicians and staff. While hospital administration would like to change this, a venture into preventative care the establishment of an HMO by the hospital was recently stymied due to the low penetration of HMOs in Knox County. The HMO coverage could have included alternative practices in the long run. With the failure of the economic venture, Polahar does not see KCH as providing alternative care any time in the near future, though he did state that "where those therapeutic regimens or traditional regimens are extensions of traditional medicine, my answer would be more likely that it might happen."
The motto of Knox Community Hospital is "Quality Health Care, Close to Home." And the hospital does provide a wide variety of allopathic services. Holistic health care, on the other hand, is currently lacking from the hospital's resources.
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