We live in a beautiful region, with diverse offerings for a variety of
tastes – outdoor activities, family life, quality culinary choices,
education, etc. It is a great place to live. That’s a key driver
for the continuing residential growth in our region, particularly those
who are achieving that milestone of retirement. Typically, that age of
retirement is around that benchmark age of 65 years old, and lots of our
statistical data uses that age target for measuring a variety of items.
With the Baby Boomer generation crossing this threshold at the rate of
10,000 people per day, how communities adapt to that aging of our population
is crucial to the ongoing vitality of that community. This creates challenges
for our healthcare delivery system, as it is important for us to efficiently
plan and adapt to the growing needs of a community.
Atlantic General Hospital’s website,
www.atlanticgeneral.org, provides access to our Community Health Needs Assessment (CHNA) that
we are required to produce every three years (our community is defined
as Worcester County and the southeast portion of Sussex County, Delaware).
The CHNA compiles the most recent population statistics available at the
time, analyzes the trends associated with that data, and queries the community
to understand their needs. Population trends show that over 25% of those
who live in our community are over the age of 65, and 75% of the growth
in our community are people over 65. According to those who live in our
service area, the No.1 health concern is cancer. Compounding this health
concern in our community, three of the top seven barriers to healthcare
cited by members of our community through the survey were “no transportation,”
“service is not available in our community,” and “doctor
is too far away from my home.”
Cancer is one of the leading causes of death in the United States. In Maryland
and Delaware, the incidence of cancer is actually higher than the U.S.
average. Even more concerning, the mortality rate for Worcester County
and Somerset County residents diagnosed with cancer is nearly 10% higher
than the Maryland statewide rate. More than 750 new cancer cases are diagnosed
in Worcester, Somerset and southeast Sussex Counties every year. There
is no question that cancer treatment is a pressing need for the residents
of our community.
In 2011 the Institute of Medicine (IOM) commissioned the Committee on Improving
the Quality of Cancer Care, who published a report in 2013 entitled “Delivering
High-Quality Cancer Care: Charting a New Course for a System in Crisis”.
The report states, “There are major disparities in access to cancer
care…These disparities are likely to become more pronounced as
the population grows older…” This aging of the population
will cause the number of cancer cases diagnosed in the U.S. to nearly
double over the next 15 years.
I’ve shared a lot of information and statistics to illustrate a challenge
for our growing community. Cancer diagnosis and care has improved tremendously
over the past few decades, so much so that cancer is now considered a
“chronic illness” rather than the potential death sentence
of the past, with over 60% of those diagnosed with cancer being cured.
The changing treatment regimens allow patients to take oral medications
at home, or be treated with portable chemotherapy infusion pumps so they
can continue with their normal routine.
These changes create new challenges when the cancer treatment is being
managed from longer distances. What happens when there is a crisis or
a problem with the side effects of treatment while the patient is at home?
A recent study showed that cancer patients visit emergency rooms twice
as much as our Eastern Shore population, when their cancer provider is
20 miles or more away. This is difficult for the emergency room physicians,
because they are not cancer treatment specialists; and it is difficult
for the patients, because it may be disruptive to their treatment. Long-term
survivorship also creates new challenges of making sure that communities
have the appropriately trained primary care providers and specialists
to understand the potential long-term effects of radiation treatment or
It is clear, now is the right time for those who choose to live in our
community to have the appropriate care available to them close to home,
when they need it. Cancer treatment and care has been significantly improved,
so that most cancer treatment is community-based. This is better care
for patients, because the treatment is more accessible and more convenient.
This is better for the families of loved ones being treated, because resources
are closer to the patient. In a community such as ours, this is the type
of care that is much better when it is care delivered together.
Michael Franklin joined Atlantic General Hospital and Health System as
President and CEO in October 2005. Prior to coming to Atlantic General
Hospital, he served as the Chief Operating Officer of Shady Grove Adventist
Hospital in Rockville, MD, and has served in healthcare management for
over 25 years. Franklin is a Fellow of the American College of Healthcare
Executives, holds a Bachelor of Science in Health Sciences degree from
Old Dominion University in Norfolk, Virginia, and a Master of Science
in Healthcare Administration degree from Virginia Commonwealth University
- Medical College of Virginia in Richmond, Virginia.