Letter to the Editor

Dear Dr. Knight,

As an academic-trained EP practicing at a small, community hospital, I saw the title of your column [“Saturday Morning at a Small Community Hospital”, EP Lab Digest 2010;10:4.] and started reading with an expectation of the typical conclusion recommending referral of EP patients to quaternary care centers. I was very surprised and pleased to hear about your experience at a small community hospital, as these are the reasons I chose to leave the academic center. First, there is much less inertia to enact changes in these hospital systems. These changes allow our small hospital to be much more responsive to patient preferences and quality improvements. As you noted, the administrative layers, though present, tend to be more easily negotiated. Finally, community hospitals are uniquely poised to contribute to comparative effectiveness research as they more realistically represent the U.S. patient population (community hospitals represent over 90-95% of all admissions to U.S. hospitals and as such provide the vast majority of clinical care). It was a refreshing read. Community hospitals are the true safety nets of U.S. patient care. Thanks for sharing your perspective.

Regards,

Jeffrey L. Williams, MD, MS, FACC