Amy Chang, a registered nurse in Brigham's renal transplant office, said she's unsure about what consolidation will really mean.
"I'm afraid it will be too big--very impersonal," Chang said. "I think you can lose a lot if that's what happens. If you want to satisfy the patients you're dealing with, you need to be catering to them. You're talking about care, not business."
Some skeptics said concerns about the effects of consolidation--whether they be layoffs or depersonalized patient care--are premature. They doubt increased cooperation will ever happen.
Said one clinical fellow at Brigham and Women's, who refused to give his name citing a hospital policy against speaking to the press without notifying the public affairs office: "I don't think they're going to eliminate competition. I don't think they'll change."
He said, "It seems to me if it happens it will probably be a pretty long process. They may in 20 years, but there's a lot of big egos."
Another clinical fellow was also skeptical of any plans that would centralize certain departments in certain hospitals. "The sub-specialties have a long tradition at all the Harvard hospitals," he said. "No one's going to give them up without a fight."
Still, some said the fight is already over, and that they are resigned to a new era of collaboration and, perhaps, downsizing.
"I think Tosteson's right. That's the way it'll have to go, and it's the way we've already gone," Rabinowitz said.
Kery said there's already a lot of cooperation between some of the Harvard teaching hospitals.
"In the blood bank area, the Brigham and Women's and the Children's Hospitals are already looking to consolidate these functions into one," he said, adding that the two hospitals also already have a joint program in neo-natology.
Children's Hospital and the Dana-Farber Cancer Institute already share patients, he said.
No one really knows yet what the five-hospital talks will mean in terms of layoffs, the structure of a new health care system or the quality of patient care.
Certainly, though, lots of people--from Hillary Rodham Clinton to Harvard Medical School Students, from hospital department chiefs to hospital cafeteria workers--will be following the talks closely during the next six months, and hoping for very different results.
Eleven men (plus an anti-trust lawyer) in a smoke-filled room will decide the future of elite medical care in the Boston area. Then again, they're hospital chiefs, so maybe there won't be any smoke. Nevertheless, at the urging of Medical School Dean Daniel C. Tosteson '44, the leaders of five Harvard-affiliated hospitals have begun to talk about, well, how to talk. Some of their employees are afraid of the consequences of...
I think it's going to be something that's very painful. That means a lot of jobs lost. Janice Burnette, research coordinator, Children's Hospital
It seems to me if it happens it will probably be a pretty long process...there's a lot of big egos. clinical fellow, Brigham and Women's Hospital