What Philadelphia Is Losing When It Loses Hahnemann Hospital

A devastated Hahnemann doctor calls the planned closure of the 171-year-old safety-net hospital the “consequence of valuing money over the health and safety of tens of thousands of the city’s people.”

Protesters outside Hahnemann University Hospital on June 27, 2019. Photo by Matt Rourke/AP

As a physician, I recently have been devastated by the news that the hospital in which I practice and teach is closing. Philadelphia Academic Health System, LLC, the owner of Hahnemann University Hospital, announced on June 26th that the 171-year old institution would close in about 70 days. Immediate steps toward closure then decreased the number of patients admitted and treated at Hahnemann by 50 percent in just seven days.

These events have shaken my faith in what had been a firm ideal for me: The public good of a safety-net hospital is so essential to our society that it must be maintained in Philadelphia at any cost. Safety-net hospitals such as Hahnemann, which serve mainly a low-income and vulnerable patient population, play an important role in maintaining the health and safety of the public, just as police and fire departments do. This public good cannot truly be driven by a profit motive, and it is difficult to reconcile a safety-net hospital such as this being owned and operated by a for-profit company.

The purpose of our city’s health care professionals is to promote and foster the health of the city’s people. Hahnemann is the place in this vast world where I have the ability to make a positive difference. I am now watching its quick demise. It is difficult to look at myself in the mirror these days without feeling a sense of failing my patients and trainees. With that, I write a message to my Hahnemann colleagues and trainees, and to the people of Philadelphia.

To my Hahnemann colleagues, every physician, nurse, therapist, dietitian, technician, custodian, and assistant who supported the hospital’s mission to care for every person who came through its doors: I am proud to have worked with each of you.

In a world that can feel apathetic, we cared. We cared no matter whether it was someone in need of an organ transplant, or an undocumented woman actively giving birth, or a patient with a massive heart attack, or a homeless person on dialysis. I saw your principled drive to make the world a better place reflected in your eyes and your actions every day, and now I see it in your tears as our hospital slips away. I wish you all the best and I hope that we continue to work together, but if not I hope that our paths cross again soon.

To all of the orphaned medical trainees at Hahnemann, the record number of students, residents, and fellows who have lost their training program due to the hospital closure: I am grateful and honored to have been given the opportunity to teach you.

I became a medical educator at around the same time I became a parent. Raising children, in my opinion the most challenging educational responsibility, has informed my skills in medical education. Having three children under the age of 10, I found that the most difficult part of parenting is not waking up in the middle of the night to a crying baby or learning to navigate toddler meltdowns, but dealing with the living mirror that is a child. They imitate our behavior, despite our counsel against it. No matter how many times I tell my children to use manners or to be respectful of others, when my own behavior does not reflect my words, they follow my behavior, not my words.

In medical education, we call this the “hidden curriculum,” the things students and trainees learn from watching their educators’ actions. My residents and students are my living mirrors: I must behave in a way in which I expect all of them to behave, in a manner that improves the lives of my patients to the best of my ability. To fail them is to fail the public, our patients. Every student and resident that I taught was a reminder of my purpose as a physician, reinforcing my necessity to live by ideals. I am extremely grateful to all my students and residents for reminding me of why I wake up and walk into the hospital every morning. I am ultimately a better physician and human because of you.

To the people of Philadelphia: While it has been an honor to serve your health needs, I am disappointed because we have failed ourselves.

We have used and heard the phrase “City of Brotherly Love” so much that it has lost its meaning. Our wonderful city, composed of incredible people, has a moral responsibility to care for every person in it. There is much in our country’s health care system that does not make sense, most of which is trying to reconcile profit motive with addressing the health needs of all people. Allowing Hahnemann University Hospital, a safety-net hospital, to close is the consequence of valuing money over the health and safety of tens of thousands of our city’s people. If the hospital is to close and the property on that block of Broad Street between Vine and Race streets is developed into high-rise apartments, it will forever be a mar on our city, representing a time when we the people, with our government, businesses, and academic institutions, failed our own city.

Whatever happens to Hahnemann University Hospital and the land on which it stands, let that city block forever be the living mirror that reminds us that we will never fail ourselves again in this way, that the health of this city full of our brothers and sisters is more important than money.

Kevin F. D’Mello is an academic hospitalist at Hahnemann University Hospital and the director of quality improvement and patient safety in the Department of Internal Medicine at Drexel University College of Medicine.