Dr. Ezekiel Emanuel: Are hospitals becoming obsolete?

As many patients continue to receive safe and effective treatment in settings outside of the hospital, traditional hospitals will grow smaller and close, argues Ezekiel Emanuel, MD, in an op-ed for The New York Times.

Dr. Emanuel is a physician and author perhaps best known as the architect of the ACA. In his op-ed, Dr. Emanuel says hospitalizations have been steadily declining since 1981, which is in part due to the accessibility of services such as oncology treatment and orthopedic surgery at ambulatory surgery centers and outpatient clinics. He attributes this shift partly to technological advances and partly to the increased risk of infections in hospitals.

"As these trends accelerate, many of today's hospitals will downsize, merge or close. Others will convert to doctors' offices or outpatient clinics," Dr. Emanuel writes. "Those that remain will be devoted to emergency rooms, high-tech services for premature babies, patients requiring brain surgery and organ transplants, and the like."

Dr. Emanuel says healthcare leaders argue this transition away from hospitals will cost valuable front-line jobs, but that jobs created in other clinical spaces will more than make up for these losses. He also calls on federal antitrust regulators to carefully monitor consolidation among health systems, which many claim passes savings on to patients, but which Dr. Emanuel argues actually monopolizes markets.

"Instead of trying to forestall the inevitable, we should welcome the advances that are making hospitals less important," Dr. Emanuel writes. "Any change in the health care system that saves money and makes patients healthier deserves to be celebrated."

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