If You Build It, Will It Stay?

You don’t have to have seen the movie, Field of Dreams to know its most famous line: “If you build it, he will come.”

The 1989 movie tells the story of an Iowa farmer who hears a mysterious voice instructing him to build a baseball field in his cornfield. One of the players who eventually emerges from the corn is Shoeless Joe Jackson, the legendary baseball player whose career ended after he was banned from baseball for his alleged involvement in the 1919 Black Sox scandal.

But in Field of Dreams, Shoeless Joe isn’t interested in money, fame or winning.

He simply wants to play. He wants to play the pure game.

The American hospital also began with a simple idea.

Built to Help
Hospitals weren’t originally built as the massive businesses they are today. Many were founded by physicians, religious organizations, philanthropists and community leaders who believed that caring for sick people was a responsibility worth taking on.

Someone was sick. Someone needed help. So, they built a hospital.

There were certainly financial realities. Buildings had to be maintained, employees had to be paid and medical equipment had to be purchased. But the fundamental mission was straightforward: take care of people who need care.

For generations, hospitals were viewed not simply as places of business, but as community institutions — places people could turn when they were sick, injured or facing a medical crisis.

When the Game Changed
Over the decades, the game has changed — and so has the scoreboard.

The neighborhood hospital has become part of a much larger health care system. Hospitals have merged and expanded, acquiring physician practices, building outpatient networks and competing for patients and market share. Some now generate billions of dollars in revenue. Private equity has entered the field as well, increasingly acquiring medical practices, nursing homes and other health care service providers.

The players have changed. The stakes have grown. And the game has become much more complicated.

Remembering the Pure Game
Maybe it’s time to remember the pure game.

Not to turn back the clock. Medicine has come an incredibly long way, and patients today benefit from treatments, technology and expertise that earlier generations could never have imagined.

But perhaps we need to remember why hospitals were built in the first place.

A patient walking through a hospital door isn’t thinking about market share. A parent sitting beside a child’s hospital bed isn’t thinking about operating margins. Someone hearing a frightening diagnosis isn’t thinking about revenue growth.

They’re thinking about getting better. They’re looking for someone to help.

And that’s what the doctors, philanthropists, religious organizations and community leaders who built America’s early hospitals were trying to provide — a place where people could turn when they were sick and someone would be there to care for them.

When the Field Disappears
Shoeless Joe didn’t want a better contract or a bigger stadium. He simply wanted to play baseball — the game he loved before everything became complicated.

But what happens when there is no field?

For too many communities, that’s becoming a very real question. Hospitals — especially rural hospitals — are under enormous financial pressure. Some have eliminated services or are struggling to keep their doors open. Others have closed altogether.

For the communities they serve, a hospital isn’t simply another business. It may be the only place within miles where someone can deliver a baby, treat a heart attack or receive emergency care.

We need hospitals that are financially healthy. But we also need hospitals that are there when people need them.

The game has changed. Health care has become a much bigger business.

But the reason we built the field hasn’t changed. Someone, somewhere, is going to need it.

Happy reading,
Suzanne Daniels, Ph.D.