by Nick Jacobs

Bigger is better? Better is bigger?

The most incomprehensible part of this theory of business to me is that we spend billions of dollars on small, boutique experiences every day in this country, yet we have begun to look away from our most precious nonprofit's, small and medium sized hospitals. Could it be that health care is so complex and we are so confused about the nuances of this health care world that we embrace the herd mentality? Or is it that, we are so enamored by the lore and promise of technology that we assume that all smaller facilities cannot afford to purchase in order to keep up with the Jones of the medical industrial complex.

We should take a lesson from the War in Iraq where the most heavily funded war machine in the world is disrupted day after day by cell phones and IED's, a.k.a., roadside bombs.

Conversely, it is amazing to me that the simplest of things, a stethoscope, in the hands of a talented physician, can diagnose, more than any of the most sophisticated diagnostic technologies, complex ailments that don't always appear in digital depictions of that affected area of the body.

Cottage Hospitals are still embraced in England, and spa hospitals are the norm throughout Europe. Why is it that we are beginning to reject the fact that there is a place for small and medium facilities in our country? If your goal is to have an infection free surgery, ask about the infection stats at the various hosptial's where your doctor is credentialed.

Yes, of course this is personal, but it is amazing to me that our society continues to embrace the mega Systems as the only way to fly as we are many times pushed, tugged, stacked, ignored, and infected in some of our health care factories.

In a recent conversation with a former cardiac center employee from one of our nation's finer facilities, I explained that I had personally watched one of my closest friends forgo the opportunity to be treated locally so as to ensure their safety and to enjoy the professionalism afforded them at this institution. He died from an infection contracted. After describing this to him, he nodded and replied, "Yep, they have a bad bug there that they just can't seem to get rid of . . . " Could it be that sometimes smaller is better?