Hospital Problems Cited
T o Group By Dr. Owsley
(continued from pag? 1, 1st f?c.)
the Horn in the West opened, the
hospital became fully approved.
The hospital retained iU full ap
proval at the imped ion last spring
and afedwad program in avary d?
part ment. There has been consid
erable improvement even since the
inspection and thera arc plans
'for continual advancement.
What wa have attained la best
expressed by the certificate of ap
proval which I show you now. It
is the opinion of aaay physicians
and hospital authorities that a hos
pital is not deserving to stay open
unless it BMU tkeae standards.
I can assure you that many of
our neighbors in all directions do
not meet these standards. It is not
my purpose or that of the hospital
board to speak 111 of any of 'our
neighbor institutions, but this is
brought up merely to point out
how fortunate we are. I believe
that our attitude can best be de
scribed in the words of Jgtui Brad
ford on seeing a condemned man.
Tftese words were, "There, but for
the grace of God, goes John Brad
ford."
More than the academic rating,
fine record* and adequate equip
'merit the boapital imiu survival,
the difference between life and
early death, to many people in
this territory perhaps even some
under the sausd of my voice. Per
haps you may say that if we had
no hospital you have sufficient
means and fast ambulances which
would keep you sal* I must point
out to you, however, that this is
quite true in many instances but
in a goodly number Of instances
such thinking would be a fatal fal
lacy.
While meant of communication
and transportation have mad* tre
mendous strides to have the agents
which may produce death become
swifter and more terrible. I
should not Jiave to point out to
you that we have admitted mafiy
people to Watauga Hospital who
could not afford to bleed for an
other twenty-five, fifty or a hun
dred miles or wbe could not wait
for oxygen or other medical treat
men for even an additional fifteen
or thirty minutes.
Ev^n though you do not plan
and hardly expect to be in a po
antagonistic to the hospital mutt
feel a bit of comfort that it and
its staff are always available and
on the alert for them.
I also remind you that the hoa
pital perform! a very essential
wilu! for tk? ApfdMkiin State
Teachers CaUege. Wert it not far
the hospital, the collet* would be
forced to provide infirmary a erv
MkriU atudeati. ~ ?
More important than this, bow
ever, is tb? alow but ever craping
knowledge of the hospital's prew
race and the feeling of teepritf
that it affords the pareats of tiie
young men and women who aV
tend school here in Boone.
Let ttf now consider thcae who
have helped the hospital since iti
re-organization. Naturally we art
indebted to many persons for the
ground work that was laid for our
present organization, but we art
primarily concerned with the instK
tutioa a* it acist* today Many of
you public spirited citizens cor*
tributed nooney for the original
equipment and later for the buM
ing of the nurses home. The phyfc
sician&. and their families hatt
asad* important contributions of
time, effort, personal service,
equipment and money. The Dukt
Foundation has provided guidance
and money on numeroua occasional
The Appalachian State Teacheri
College haa made many and in*
porta at contribution* to the hos
pital since its re-organization, an|
it , was only through their kindness
and cooperation that the preaent
magnificent nurses residence could
be constructed. The legal agrea
ment existing between the hospital
and the college in regard to stu
dents and faculty hospitalization la
of mutual benefit. It would be un
fair not to mention the fact that
there waa state and federal aid la
the construction of the nurses
home.
Let us bow consider the present
situation of the hospital. As I
hare said the medical staff is well
organized and efficient. The rec
ords are adequate and up to date.
The hospital is well-equipped.
There arc some problems. There
is a shortage of one or more nurses,
there are also openings for a dieti
tian and an administrator.
There is a moderate deficit of
money. This deficit amounts to ap
proximately 10.99% of a year's in
come/ This deficit does not origi
nate from lack of conservative,
careful, even frugal management
fall #|P income,
Tb iMpiM receives nothing from
th? medically indigent. Those per
sons who are receiving public as
sistance through the department ef
public welfare represent a leas of
$11.46 per patient per day since
the at ate allowance is only M
per patient per day. You would
gather Iron that, tad quite cor
rectly so, that it coata $17.40 per
day for each patient that is hospi
tallied. This may seem staggering
but it la actually about two dollars
per day lew than moat hospitals In
this region. Is It not striking that
the indigent make up 10% ot our
total hospital days and our deficit
is 10.#% of last years income'
To my miqd the financial diffi
culties of the hospital are quite a
handicap, but the lack of public
understanding and sympathy, mani
fest In man* ways, is far worse.
Let me elaborate.
First, there are rumor*. Peoole
like to exaggerate. People who
feel guilty about their conduct
toward the hospital even like to
lie' a little. This leads to many
stories which might aply be called
hybrtda, that la. a strange breeding
of troth and fiction. A reasonable
person must know that a aurtrical
patient's expemes are tremendous
on the day of operation if a very
extensive operation ia necessary.
During such a day the services of
three or four members ol the op
erating staff are necessary far
sometimes aa long aa tlx hours.
Hie service of the anesthetist is
necessary for that length of tisne
Many of Hie supplies which are
used in aaodern surgery are very
expensive. In prolonged operations
several Mood transfusions may be
necessary hatore the patient leaves
the Operating table.
Most operations occur on the
day following the patient'a admis
sion. On that day the necessary
laboratory work, the first day room
charges, and all of the operating
room charges, which I have juat
mentioned, are added to the bill
After the first day moat surgical
patients charges are quite nominal
and rarely run very much ever the
charge for the room accommoda
tion.
' There are many expensive ((rugs,
medications and treatments which
are necessary for medical patients
which alao tend to make the first
few days of hoapitalixatiob or even
all of them expensive
It would seem that no fair
minded person would compare a
bill for such service with a bill
incurred by a patient with a very
minor illness who waa hospitalised
at eome institution within this re
rgion which did not offer major
hospital facilities. You have my
word that the cost per 'patient per
day in such institdtiona is approx
WHXIy.rttT oven sligfctl* Aight
er than-the sane cost at Watangs* ?
Hospital.
There waa recently a malicious
tale circulated in Boone about seme
of the maintenance which ia per
petually being carried out. This
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rumor had it that the operating
room ?u being repainted became
jf thl? were not done imme<4iaWy
tha Health Department would ciaae
the Institution. The aimple fact
la that cleanliness aad appearance
aaaintainod at all ttutrs in the op
erating room meeta iuch standards
m would awn fantastic to the
average layman.
There is a continuous job of]
scrubbing, cleaning, re-sterilization,
re-packing and malntonace of
thousands of Items which are nec
essary whether these items are
used or not. To the housewife
this would be comparable to wash
ing every utensil, knife, fork,
spoon, plate, and other equipment
in the home several times a day
whether they wore used or not.
Such stories are unfortunate.
Another place where there is a
large lack of public understanding
and sympathy is in regard to visit
ing hours. Visiting regulstlons at
the Watauga Hospital are less
stringent than in most institutions
where major surgery and other
major medical procedures are not
done if visiting hours are even
ooatiniMua. I can assure that our
hospital staff is strained almost to
the point of desperation at times
to get their jobs dono in order
that visitors may be permitted dur
ing the heurs set for visiting.
Actually H we consider the pa
tients' welfare, and the patient's
welfare alone, the present visiting
hours are far too long. There is
too much visiting of patients by
persons who do not even know
them. The attitude of many par
ents in Watauga County towards
hospitalization of their children is
for the lack of a better word,
abominable. I have made up my
mind that as far as the surgical
service is concerned, I shall in
sist upon those practices which 1
think are in the best interest of
the patient
Some af the lack of public un
derstandinj and sympathy arises
from ? lewra) "kick the e?" at
titude. By this I mean an attitude
which many of ua had at children
M we walked to school. We would
even go out of our way a few steps
la order to give some empty tia
can a few swift kieka in the direc
tion of the school building When
we tired of this we left the can.
probably to be given several addi
tional boosta by other children
with the same attitude. Thus, you
see that anything standing out ia
the open frequently comes la for a
few unprovoked kicks. The hoapi
tal it not as well-supported by the
public as it should be. In this re
gard I would like to be left out
from personal consideration be
cause I am fully occupied with a
full time job an ample practice
and a twenty-four hour a day.
seven day a week responsibility. I
am speaking however of those per
sons who have been influenced to
go elsewhere when the hospital
aeed the private paying patients,
and in thoae eases whent the hospi
tal facilities are adequate and
there kre physicians on our staff
who could competently do the
tarn* type of woVk for which theae
peraonf are leaving Boon*. It la
May to s*e that a higher census of
paying patients would make a more
favorable ratio of private versus
indigent patients. If people con
tinue to go elsewhere in large
numbers for their hospitalisation
the day will not be long off when
there will be no hoapital here.
Now rapidly let us consider
what Is necessary. The county
should pay the full cost of hos
pitalization for those persons who
are receiving public assistance.
This fa done in many counties in
the State of North Carolina. If at
all poaaible something should be
paid from public funds on those
persona who are Investigated and
found to be medically indigent by
the department %l public welter*
Mind you I Mid they ahNld par
the hospital emit etl the patients
hospitalized 1 do *? believe that
? lump huh of subsidy is desirable.
I think the same treatment should
he accorded othtr institutions in
this vicinity when they hospitalise
our Watauga indigents. It wtiuM be
only fair to levy taxes to pay for
such cost since the present county
polio is in effect A 10% tax on
the paying patient. The hospital
has not been collecting this tax.
however, since our deficit la as you
know 10.0% of our last . years In
come.
What is more necessary even
than remuneration for hospital aer
vices rendered the indigent la a
broader base of public support for
the hospital or simply more hospi
tal boosters. In the past years too
few have cared and far fewer have
helped. Personally, I have contri
buted more than $10,000 to the
hospital in the last seven years.
Mrs. Owsley worked as s volunteer
for one yesr prior to attending
Appalachian State Teachers Col
lege and his pow worked as a
volunteer for the past two years.
She Is now doing a full time job in
thft record library and also substi
tuting for the dietitian. She must
soon find It necessary to quit both
jobs, because she Is rapidly reach
ing a state of complete physical
exhaustion, which i| detrimental td
her health. "
For seven years I have lived In
a crisis. Each year t^at I have been
here has been a major financial
croasroads for the hospital. I know
of no other person of equal train
ing and professional standing who
has eyen a part of the concern,
worry, and insecurity that 1 have
shouldered for seven years. Most
of the outstanding general sur
geons in North Carolina are fny
personal friends and acquaintances
ttr.unb the Nmk CvolMu Sorfi
c?) AimciiittoB, mi 4 I know suffici
ent of their circumstances to as
you that everything I era auy
In* 1* true. Financially and physi
cally, I can do better fer myaelf
and lay family elsewhere I ihall
be forced to do thin if yen the pub
lic don't shoulder more of your
responsibility for yeur own health
and safety. Aside from my person
al feelings and participation 1b the
hospital pracram, there must be,
public andrrstauding and more
support of the hospital by utiliza
tion of the hospital faculties and
the skill* of the other members of
the medical staff in erder that thin
institution may grow and advance,
or even exist. There must be more
cooperation o> the part of the pub-4
right, profq
W ind dare
tad conduct
and relathx
muit t* a i
Them must Im less abwse by lH*'
public of our employees especially*
those younf ladies la the financial
office. IB short you mud get be
hind the hospital (or your own
??ke. ft 111.
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