This week, the Oklahoma Hospital Association will gather for its 100th annual convention Nov. 13-15 at the Cox Convention Center in Oklahoma City. On May 21, 1919, around 30 representatives from hospitals across Oklahoma met at the Severs Hotel in Muskogee to form the Oklahoma State Hospital Association.
At that first meeting, founder Dr. Fred Clinton pointed out the primary objectives of a hospital:
- Care, cure and education of the sick
- Training of physicians and nurses
- Extension of medical knowledge and the prevention of disease
He also outlined the purpose of the Oklahoma Hospital Association:
- Promote the welfare of the people so far as it may be done by the institution
- Care and management of hospitals and dispensaries with efficiency and economy
- Aid in procuring the cooperation of all organizations with aims and objects similar to those of this Association
- Do all things which may best promote hospital efficiency
Although much has changed since, Clinton’s rationale for founding and sustaining the Oklahoma Hospital Association is as relevant to the organization’s mission today as it was then. In this Q&A, current OHA president Patti Davis discusses the origins of the OHA, the evolution of hospitals and health care and her vision for the association as it enters a new century.
What was happening during 1919 in Oklahoma and in the health care world?
For most of human history, people didn’t go to hospitals to seek medical treatment. Instead, they had physicians visit them in their homes, or they relied on family care. In rural, agrarian settings, multiple generations of families often lived together. The younger, healthier family members took care of the elderly and sick as best they could.
Hospitals in the pre-industrialized world, on the other hand, were like alms houses for the poor, the homeless and the mentally ill. They were mostly staffed by religious organizations.
Industrialization changed that as people began to move to cities and more densely populated areas. Fewer extended families living together made the old in-home care model much harder. At the same time, medical science was growing by leaps and bounds. Florence Nightingale helped to popularize the idea of a professional, well-trained nursing workforce; hospitals successfully deployed anesthesia to help perform surgeries; and medical training became more professional and precise. The demand for the modern hospital was clear. And the medical community finally had the workforce and science it needed to meet that demand.
By 1919, hospitals in Oklahoma weren’t only charity organizations run by volunteers, they were professional institutions delivering quality health care. The formation of the Oklahoma Hospital Association was a natural result of that progress.
The world has changed a lot in 100 years. Has the mission of the OHA?
When you read what Dr. Fred Clinton was saying in 1919, you can tell that in many ways the OHA hasn’t changed at all. We are still working for “care, cure and education of the sick.”
We are still working to help hospitals promote the welfare of our people and to ensure that individual institutions are working cooperatively toward that goal. We do that by sharing best practices and resources, constantly educating ourselves and members about new technologies and new developments within health care.
Of course, the way we do that today is more sophisticated than it was 100 years ago. For instance, we now have an entire department dedicated to helping our member hospitals improve the quality of care they provide. We are harnessing the collective power that comes with being able to provide experts from all over the state to work on collective issues.
So, the OHA is largely performing the same mission but in a new environment. What makes today’s health care landscape dramatically different than it was 100 years ago?
What has changed dramatically — beyond improvements in medical science — is the creation of Medicare and Medicaid during President Lyndon Johnson’s administration in the 1960s.
It’s hard to overstate the difference this has made. Before Medicare, people over 65 found it virtually impossible to get health insurance. A lot of seniors were simply unable to afford the care they needed and endured sickness and suffering. Others scraped by, but at the cost of eventually bankrupting themselves and their families in the process.
The creation of Medicare (for seniors) and Medicaid (for low-income Americans) changed everything. First, and most importantly, it increased the quality of life, the health and the life expectancy of seniors. Second, it greatly enhanced the ability of one generation to pass on wealth to another. Third, it funded additional payments to help train physicians through graduate medical education programs, allowing us to turn out a steady supply of highly trained medical professionals. Finally, it had positive social consequences. Along with the Civil Rights Act of 1964, it worked to desegregate the provision of hospital services.
Today, the Medicare and Medicaid programs are extremely popular and, frankly, are things we take for granted. It’s interesting to remember that, at the time, they were controversial proposals and their passage was no sure thing. They stand as a great example of how political leadership really can impact the trajectory of health outcomes and change (or even save) people’s lives. We are at a similar crossroads today when it comes to the issue of accepting federal funds in Oklahoma to reduce our very high rate of uninsured residents.
What are OHA’s biggest goals as it enters its second century of existence?
Our most immediate and urgent need is to reduce the uninsured rate in Oklahoma. We have the second highest uninsured rate in the nation. Families without insurance face economic devastation when someone gets sick. They also consistently miss out on the kind of preventive medicine that can save lives and ultimately drive down the cost of care. OHA supports the Medicaid expansion ballot initiative, State Question 802, for this reason.
We also need to focus on workforce development. Oklahoma already has shortages when it comes to primary care physicians, nurses and other medical staff. Meanwhile, 10,000 people a day in the U.S. are turning 65. People are living longer because of improvements in technology and research, which means increased demand for services. We can and should find a way to meet this demand by supporting all the various public and private programs and schools that train our doctors, nurses and other medical professionals.
(Editor’s note: The Oklahoma Hospital Association has purchased advertising on NonDoc in 2019, and this piece appears as part of their advertising package.)