Hahnemann University Hospital, once a critical Philadelphia safety-net hospital, closed down last summer and remains unused to this day. The Inquirer reported on March 11 that the Philadelphia Department of Public Health is exploring the possibility of reopening Hahnemann to provide additional hospital beds for a surge of coronavirus patients in Philadelphia.
The facility could be used for a variety of services to relieve strain on the health-care system, not necessarily for the treatment of patients infected with the coronavirus, officials said.
We enthusiastically endorse reopening Hahnemann, with its unused 496-bed capacity, as a potential resource to help us combat this impending public health crisis. But we would emphasize that our city faces many additional, previously existing public health challenges that could be mitigated in part by Hahnemann’s repurposing.
Philadelphia and Pennsylvania continue to struggle with a drug overdose crisis associated with opioid use disorder. Philadelphia’s old housing stock makes children vulnerable to brain injury from lead poisoning, and many of those children have no identifiable haven for safety. And we face other social drivers of poor health, including food insecurity, homelessness, extreme poverty, and mental health issues.
The Hahnemann building has a large cafeteria that can partner with local philanthropic organizations to provide a food kitchen for those in need. Offices and clinics can be set up to address opioid use disorder; a “safe injection site” in South Philadelphia recently failed dramatically and might be better housed at Hahnemann. The now-closed hospital could become a site for solving problems of homelessness, for example, by providing temporary shelter, meals, and offering mental health services. Rooms at Hahnemann Hospital might also be refurbished as temporary safe housing for families dealing with childhood lead poisoning while their homes get repaired to be safe from lead.
This repurposing of Hahnemann Hospital may seem far-fetched today, but almost every day we walk by a reminder of a time when Philadelphia proudly hosted a publicly supported hospital, built with the intent of taking on safety-net roles. A few steps from the nursing school at Penn stands a plaque erected by the Pennsylvania Historical Commission, celebrating the former site of Philadelphia General Hospital, the nation’s longest-running public hospital, founded in 1729.
“PGH,” as it was fondly called, served our city well for almost 250 years. Patients were not turned away or denied care based on their ability to pay. PGH was supported by municipal taxes, charitable donations, and medical schools whose students and residents received training there. William Osler, an icon of 19th-century American medical practice and education who is often referred to as the “father of modern medicine,” pioneered his method of bedside clinical teaching on its wards. It also housed one of the country’s oldest and most prestigious schools of nursing, founded by Alice Fisher, an English nurse and colleague of Florence Nightingale.
PGH finally closed in 1977, with its buildings aging and Medicaid and Medicare emerging to allow other hospitals to take on some of its safety-net role. But today’s medical costs continue to rise, and some 28 million Americans remain without health insurance. That’s why other large cities still proudly support traditional public hospitals: Bellevue in New York, Grady in Atlanta, Cook County in Chicago, Los Angeles County/USC in LA, and many others.
A truly public hospital and health center, centrally located and devoted to urban health concerns and epidemic response, might be able to survive, even flourish — if it could start with a base of Medicare and Medicaid insurance, supplemented by city and state taxes, charitable foundations, and regional academic medical center support. We should find the means to return Hahnemann to its appropriate mission: serving Philadelphians with medical need.