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» Martin Luther King Hospital, Los Angeles, CA The Truth, The Lies and The Myth

Martin Luther King Hospital, Los Angeles, CA The Truth, The Lies and The Myth

Seeing Martin Luther King Hospital close kind of reminded me of the Wizard of Oz, or perhaps more accurately the hit musical ‘Wicked’. it seems like everywhere you turned the closure was celebrated as a triumph for good, and the downfall of evil. You could almost hear Los Angeles Times staff members chanting “Ding Dong the Witch is Dead”. Even before it opened newspapers were trying to turn the community against MLK and question the purpose and quality of care at the hospital. I still am not certain closure of MLK was the best thing for the community, nor do I think it was inevitable.

It is true that few things were done right there, but after spending time working in nearly every type of hospital imaginable, including several rotations at MLK as a medical student, I have witnessed significant flaws in even the most prestigious and best run hospitals. The US ranks 42nd in the world for infant mortality and 46th in life expectancy.   The Institute of Medicine Studies estimate between 44,000 and 98,000 hospitalized patients die annually from medical errors. MLK is certainly not responsible for this trend, although I do suspect it may have had a higher than average rate of errors.

That being said, the brother and sister hospitals of Los Angeles did little to help to help MLK, and several of them gained from its closure. When the trauma center at MLK closed I was working at the hospital that suddenly became a trauma center to pick up the slack, and many of the designated funds. I can tell you that hospital was certainly no shining example for the quality movement in health care. The doctors, however, were actually quite good. As a matter of fact, the trauma Director (G. Hinika), who trained at MLK, is one of the most compassionate and talented surgeons I have ever seen or worked with. If I needed an operation he would be my first choice as the surgeon.

From first hand experiences, I know how bad MLK could be. At the same time, I know of horrendous occurrences at other hospitals that never made the papers (such as the sexual assault of a patient by janitorial staff posing as a doctor at another local facility that is home to some of MLK’s loudest critics).  MLK happened to be much more transparent than most hospitals out there, although not by administrative design.  If something happened, everybody knew about it, and someone would typically leak it to the press. The poor morale, unbelievable nepotism, laziness, and paralyzing politics definitely created a fire storm.

After spending time on rotations at MLK, residency at LA County-USC was like night and day. That is not to say that USC was perfect and that no mistakes were ever made. When they were made, however, there was a critical mass of people who took pride in their work, supported the mission of the hospital, and were dedicated to understanding mistakes and creating an educational experience from them so they do not happen again.  It was unusual for the same mistake to be made twice.   Incompetence was simply not tolerated, at least not in the Emergency Department, and there was a culture that sought to constantly improve and educate each other.

At MLK the culture was very different, those pushing for improvement who had pride in their work met unbelievable resistance. The inmates were running the asylum. The answer should have been get the inmates under control.  What happened at MLK, instead, could be compared to shutting down a prison because an inmate riot can not be subdued.  Clearly there is and was no simple right answer, but it seems that a better way would have been to support good doctors and nurses much earlier on, instead of letting them become consumed and driven out by the surrounding culture of incompetence.

135 Responses to “Martin Luther King Hospital, Los Angeles, CA The Truth, The Lies and The Myth”

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