Murch Photo

Aggie Murch

"Every time a patient becomes a client an angel dies." Glancing through my husband’s old college magazine those words shone from a commencement address for the young medical graduates of Johns Hopkins University. A small picture focused on an elderly, diminutive figure, prophetically warning of the medical business model that was spreading with the speed of a fungal spore after the first autumn’s rain. Increasingly hospitals were spending more on machines and less on personnel. Health care as it was in the first and middle of the 20th century had changed forever.

Orthopedic replacement surgeries have evolved to become highly beneficial procedures for both patients and hospitals. Those procedures require precise mechanical finesse. However, the surgeon is but the pinnacle of a pyramid of care. They must be supported by good doctors, nurses, therapists and a smooth running institution which, though it moves such patients efficiently through its system, never leaves them feeling like a business client. Such a hospital I found at St. Mary’s in San Francisco.

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