Emerson Bouldin ’16, the author of this post, is one of four 2014 recipients of a South Carolina Internship Grant provided by Davidson College and The Jolley Foundation. The purpose of the grant is to allow students to participate in educational internships and to explore living and working in the state of South Carolina.
I am typing this blog post at my desk, or rather a folding table, in the office that I share with the Quality director. This ‘office’ used to be the patient chemotherapy room, and the curtain hanging in the corner and the old sink behind the door remind me of that. This summer, I have had the incredible opportunity to work as an intern at Williamsburg Regional Hospital in Kingstree, SC. I’m living in Charleston, which is about 70 miles away. It takes me about an hour and a half to get to work everyday. Mostly my mind wanders about getting more coffee, but the other week I caught myself thinking about the limited resources of Williamsburg Regional.
WRH is classified as a critical access hospital. Essentially, critical access hospitals are rural community hospitals that must meet certain criteria, one of which being that the hospital is at least 35 miles away from any other hospital. The director of Quality, who I share an office with, told me that there usually isn’t enough demand to sustain a critical access hospital. They exist because without them too many people would die, simply because they live too far away from a hospital. Therefore, these hospitals receive cost-based reimbursement in order to keep their doors open. More than most places, critical access hospitals feel the pressure of limited resources. My small office is a literal reminder of that.
During my first week, I found out that a significant number of employees did not have Microsoft Word because the program was too expensive. But Microsoft Word is the least of the hospital’s problems. There are daily concerns that revolve around Medicare and Medicaid reimbursements because even the smallest changes can have significant repercussions on hospital functions. I learned that larger hospitals often don’t worry if they cannot reclaim payments of $500 or less, but those lost payments make a serious difference here at Williamsburg Regional. Even patient care capabilities are limited because there are about 25 beds in the hospital, and only 6 of those of are Emergency Room beds. A bad car accident could easily overwhelm the ER. How do we balance maintaining cost-efficient facilities and also the capabilities to respond to serious emergencies? It’s incredibly difficult.
I have developed a tremendous amount of respect for the people that keep Williamsburg Regional running. We sometimes take for granted the availability of healthcare resources and forget how difficult it can be to maintain those facilities.