Why specialize?

• Author: Martel, Judy
• Position: Indiana hospitals become popular for their specializations

How have some Indiana hospitals become synonymous with certain specialties?

There's been a serious accident up ahead, the radio traffic reporter warns. Delays could take hours, and motorists are advised to seek an alternate route. Lifeline helicopter is on the scene to transport the patient to the hospital.

For residents in much of Indiana, the word "Lifeline" immediately brings to mind Methodist Hospital in Indianapolis. Patients are flown via Lifeline from all over the state to Methodist, one of just two "Level 1" trauma centers in the state (the other is Wishard Memorial Hospital, also in Indianapolis).

How have some Indiana hospitals become synonymous with certain specialties?

Some specialties, like Wishard's burn unit and Methodist's helicopter, are the only players in town. Others, like the cancer center at University Hospital and Riley Hospital for Children, part of the Indiana University Medical Center, have well-developed and financed specialties, known throughout the state as having some of the best physicians and equipment in the field.

To develop a recognized specialty, "it takes resources, including facilities, technology and people," says George Rodman Jr., director of trauma services at Methodist.

"Multiple departments have to be committed," he says, before a hospital can develop a specialty. Even after the hospital comes up with the money, planning, research and training needed to launch a specialty, the commitment is ongoing. "Once you get started, it's never static. The commitment to quality improvement is probably the heart and soul of any specialty."

Often it's a patient's physician who knows about the specialty, and makes referrals to a particular hospital, says Bob Morr, vice president of the Indiana Hospital Association, a non-profit organization that represents its 148 members in the public-policy arena.

"Most of us are not out shopping for a burn unit," he says. "The decision is not the patient's, it's the physician's."

In non-trauma situations, individual choices are more likely to come into play, Morr continues. There are many places to seek cancer treatment, so hospitals position themselves as a place for certain types of cancer treatment and make sure referring physicians are aware of their specialties.

Dr. Steve Williams, director of the Indiana University Cancer Center in Indianapolis, says the facility within the IU School of Medicine is a National Cancer Institute designated cancer center. The designation...