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    Posted August 7, 2014 by
    New York, New York

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    Primary Health Care|NYC


    Primary Health Care|NYC


    It's 'Back to the Future' again.


    The 60s generation brought us community based comprehensive primary health care. The hospital setting, we argued, was not an efficient model to address and conserve the health of the community. Not to mention the endless Emergency Room waits, navigating one's way through a hospital campus, the lack of culturally relevant services, &c &c &c. Our shouts were heard in Washington, and via the Bureau of Primary Health Care, a national initiative was launched to establish Comprehensive Community-based Health Centers.


    As it turned out, social activists of the 60s generation were community regulars, progressively minded students, trained social workers, lawyers, urban planners, MDs, nurses, elected officials -- representing, well, the full spectrum of progressive occupations that we felt then would change the world.


    We were allowed to establish our community governed and managed centers, but only in affiliation with local teaching hospitals, from whence we derived doctors, medical students, planning teams -- credibility.  My personal affiliation was with the Boriken Neighborhood Health Center in East Harlem, as a Board Member. The Borough of Manhattan had others, including the William F Ryan Community Health Center (named for a champion of progresive health services, Congressman William F Ryan); Brooklyn had Sunset Park Community Health Center; over time, Montefiore Medical Center's Dr Robert Massad launched a network of community-based ambulatory care centers throughout the Bronx.


    Fast forward to the present, just as hospital centers admittedly were not good at managing the demands on their ERs; that, the cost of real estate has forced hospitals to divest themselves of real estate, consolidate primiary care services with other hospitals and establish primary care services on the 'corner of where we live,' as it were.


    This recent iteration of trends in primary care has had a rough path, mostly due to isolated planning and poor or no community input (a community populated, I repeat, by activists, PhDs, MSWs, Urban Planners, Elected Officials, Nurses who make up the demographics of local residents). Be that as it may, divestiture has become aggressive, viz: St Francis Hospital Center, St Luke Hospital's imminent sale of four building on its Upper West Side campus -- and subsequent consolidation of services with teaching hospitals like Mt Sinai and NY Presbyterian-Weill Cornell.


    The polemic of hospital centers vs off-campus primary care services aside, on the Upper West Side at least, we have begun to see Urgent Care Pmary Health Care stores popping up like Starbucks, banks and Duane Reades; and, although, the cost of real estate is a principal driver of divestment, several of these 'store
    fronts' are corner properties which are, ironically, prime real estate.


    THAT aside, isn't it much better to walk a few blocks of where we live to have an ailment looked at, or to have the pain eased of our child at 10PM; instead of waiting 3-5 hours in an Emergency Room, Walk[ing]-in to a hospital clinic only to wait that same 3 hours as in the ER?

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