Connecting the dots on L.A.’s health system

The need for comprehensive healthcare, including emergency care, is as compelling in South Los Angeles today as it has ever been. In fact, that need has increased significantly over the last few decades because of population growth as well as the significant increase in the number of uninsured and underinsured and the weakening of the healthcare infrastructure throughout Los Angeles.

It would be a huge mistake for Los Angeles and its residents to not give this issue our full attention, erroneously believing that it is an issue of importance only to the underserved communities surrounding King-Harbor Hospital. Although made up of many different hospitals and medical clinics -- as well as thousands of physicians, nurses and other health professionals -- healthcare delivery in Los Angeles is very interconnected and interdependent.

For example, the county’s emergency-room network and trauma system -- which determines where you will be taken in case of an emergency and how long you may need to wait for care -- is already extremely fragile. As many emergency rooms and trauma centers have closed in the last 10 years, those that remain are increasingly overcrowded, compromising everyone’s access to care and regularly resulting in diversion of ambulances.

To keep quality healthcare accessible for all of L.A., we must have a critical mass of emergency facilities and hospitals. The county must assure -- especially in the near term -- that those hospitals (both private and public) directly affected by the closure of King-Harbor receive the funding necessary to care not only for emergency patients but for walk-ins and inpatients as well. Because of the lack of available alternatives, many uninsured patients are dependent on emergency rooms as their de facto primary-care doctor. It is equally important -- in both the short and long term -- that the county increase the funding for community clinics, which are a crucial part of the interconnected healthcare system, filling in other gaps in accessibility to primary care and outpatient services.

As difficult as the last several years have been for King-Harbor and all of us who care about quality healthcare in the community, the road ahead will be no less challenging. But this rough road can also provide traction for innovations that otherwise might not have been possible.

Existing hospital and other healthcare facilities are insufficient to meet the needs in South Los Angeles. In the future, a hospital that opens (or reopens) there should consider new forms of ownership and management, and those who conceive it must recognize that a more effective governance system will be essential to ensuring that it provides the highest quality of care. That system must have at its core individuals with the necessary skill set, commitment and availability, as well as a singular interest in only doing what is right for the hospital and the patients it serves.

Thomas M. Priselac is president and chief executive of Cedars-Sinai Medical Center.