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MESSAGE to OUR COMMUNITYFor months now, we’ve watched hopefully as our legislators have engaged in heateddiscussions about the best way to reform the system. Each day, it seemed, new proposalsemerged, were revised, debated and sometimes dropped. Ideas appeared to befavored by most members of Congress or the President, only to be abandoned whenanother interest group or political faction raised objections. It’s been an emotionalroller coaster.At this writing, it seems clear that the practice of medicine—as an art, a science,a profession and a business—is about to undergo a major change. Many of us haveanticipated this change—with varying degrees of hope and excitement—for a longtime. Still, as it begins to look real, we are apprehensive about unexpected compromisesthat may not be good for patients, doctors or hospitals.As we move forward to a final bill, we are starting to pay more attention to someof the subtler details. Whatever the final proposal, ways to pay for it will have tobe found. Many in the latest round of ideas suggested are directed at making thehealthcare system more efficient; that is, both more effective for patients and morecost effective for payors.Concepts like “reducing readmissions” (a good idea that can be complicated byinner city medical and socio-economic factors) “bundling payments” (paying hospitalsand doctors a lump sum for all of the costs related to a patient’s care) and increasingthe use of “evidence based medicine” (the attempt to move the “art” of medicinecloser to a science) have been introduced into the debate. Many of these conceptsmake sense—at least in theory. But when put into practice with real patients and specificsituations, they may not always live up to their promise—and sometimes theymay even have unintended negative consequences.Much of our concern also lies in regulations that bureaucrats will generate tointerpret the new law. Here is where we most fear that disadvantages to both doctorsand hospitals may emerge.As a Hospital, there is relatively little we can do to control the debate—or itsconsequences. But, as you can see in the Report that follows, we are maintaining ourefforts to produce new initiatives and strategic program development. And—mostimportant—we are doing everything possible to nurture a culture of patient-centeredcare.Our extraordinary staff of doctors, nurses, health professionals, support staff, trusteesand volunteers is well aware that we are all here to serve the patient. We havewonderful technology at NYM, and that enables us to provide care very efficiently, butour employees are focused on the needs of the patient. In that way, they continue touphold the long held mission of New York Methodist Hospital: to provide excellentand compassionate care to the people of Brooklyn.Mark J. MundyPresident and CEOJohn E. CarringtonChairman ofthe Board