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Threat of Facility Closure Puts Pressure on Rural Hospitalists


A pair of rural South Carolina hospitals that may soon shutter their doors is the latest example of the pressure on rural hospitalists, says a veteran HM director. But hospital closures also give rural hospitalists the opportunity to carve out a niche doing medical work that best serves their community.

Marlboro Park Hospital and Chesterfield General Hospital, 15 miles apart in northeastern South Carolina, are set to close this spring as Community Health Systems—which runs the hospitals and employs hospital staff—announced it would not renew its operating lease. A new operator is being sought.

The fear of a rural institution closing is a common one for hospitalists, says Dana Giarrizzi, DO, FHM, national medical director for telehospitalist services for Eagle Hospital Physicians and section leader for the rural section of SHM.

"There's always that feeling of walking the tightrope," Dr. Giarrizzi says. "It's a fine line because you can't offer everything…there aren't enough physicians."

And while hospitals' shrinking bottom lines, more intensive reporting and quality protocols, and ongoing changes to the rules of the Affordable Care Act have roiled rural hospitalists, Dr. Giarrizzi sees the current environment as one that offers rural groups an opportunity to focus on what they do best and home in on that.

"It's really important [for rural hospitalist groups] to figure out what their niche is, figure out what works for them, and then to run that well," Dr. Giarrizzi adds. "I think it hurts them when they're pushed or when they feel like they have to do everything…you don't have that ability. These small rural hospitals serve their purpose, but their purpose isn't to serve everything."

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