1+1+1= 1 New Children’s Hospital

Posted on Posted in DrDownload

“If you can’t beat ’em, join ’em” was my first thought when VCU Medical Center announced yesterday that they were going to build a new Children’s Hospital.

I never cease to be amazed at how work is accomplished in Richmond. After the VCU Health System Advisory Board met in April without formal discussion of the largest philanthropic gift offered to a children’s hospital in history, I was disappointed to say the least. It seemed to me that VCU Medical Center was content to call the seventh floor of their hospital and a variety of outpatient facilities a real Children’s Hospital and that they were never going to be interested in collaborating with the pediatricians and the other community hospitals to build something better. Then out of the blue, they announce a new hospital for the children. A little short on specifics, but an announcement nonetheless.

How I love dreaming about this hospital! It’s a beautiful facility with kids art and happy doctors and really good parking. It’s easy to get to, and all the pediatric subspecialists are under one roof in lovely new, clean offices. My office is in the complex of buildings, too, so that if my patient needs an X-ray or complicated lab work, I can send them right over to skilled caregivers who don’t mind a little squirmy unhappiness remedied by a sticker and a lollipop. The inpatient part of my hospital has family-centered, private rooms with soft PJs and kind nurses who really understand the unique needs of children. Across the way, brilliant bench research is going on to discover what really does cause autism.

Why is it so hard to have that Dream Hospital come true?

Because 1 + 1 + 1 has to = 1 in order for My Dream Hospital to become a reality.

Three very different hospital systems have to come together to create one independent hospital for the community, and no surprise here: everybody wants to be in charge. Including me. I want to be in charge of speaking for the children. And if I were in charge, here’s what I would say:

VCU Medical Center people: You keep walking away from the table where we are all really trying to understand and include you. Remember that kid in Fifth Grade who just couldn’t get along with the rest of the Kickball Team? Don’t be him. He was a great athlete and a good person, but he just hadn’t learned how to be a follower at times when he wasn’t being a leader. You can grow into the best collaborator if you will just believe that you are able to follow as well as you can lead.

Pediatricians: You have got to speak up every single day in every way your packed schedules will allow. You have to take the time to explain to parents that their children are deprived of the kind of care that only comes from an independent children’s hospital. Children’s Hospital at VCU is ranked in USNews and World Report as 50th in only ONE specialty. That’s embarrassing for a city our size, and while we should be proud of our nephrologists, we should be ashamed of everyone who is keeping our cardiologists and pulmonologists and gastroenterologists and neurologists from thriving and developing similarly expert ranking in their fields. Our children deserve to have top-ranked professionals here at home, and the only way we’ll get them is to give them the kind of hospital they need to do their work well.

Philanthropists: You are wise to commit your resources to a cause that will change the future. The measure of a society is reflected in the status of its widows and children, and your willingness to donate an unprecedented amount of money to the children speaks a language I love. Control of this endeavor does matter, and you wisely have asked that the hospital be independent of the three systems we currently have. Compromise and collaboration are essential to the success of a true hospital for the children so don’t back down. The only way to ensure success is to force the issue and insist that the current leaders play nicely with one another and share the power as well as the money.

Parents: This is not a game. This is one of the most important projects our city will ever do for its youngest citizens. And the time is now. There is unprecedented interest among parents and community leaders to understand the challenges in building an independent children’s hospitaland to overcome them so that our children can have what every other city has seen fit to build for their children. This independent hospital can be a unifying, open source project for our city, and there will be books written about how when Richmonders finally decide to do something, my goodness don’t we do it right! Parents raise children to get along and problem solve, so it’s right that we hold hospital administrators to be what we want our children to be.

Now is the time to come out into the sunlight. “Behind closed doors” has been largely unsuccessful in all the other attempts to build a true Children’s Hospital over the decades. Todayis a new day. In the sunlight of that new day, we can bring transparency to the challenges of building an independent children’s hospital and feel the warm encouragement that will be needed to succeed.

I don’t have to be in charge, but I do have to speak for the children.


Gayle Schrier Smith, MD

author of the DrDownload


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