A small hospital's fairy sad tale: an allegory.

© 2006 Society of Rural Physicians of Canada Can J Rural Med 2006; 11 (4) O nce upon a time there was a little farming village in the valley, not far from a castle on the hill. The people in the village liked to help each other. The local healers were considered a part of their village “family.” One day, as medical knowledge and technology developed, they all decided that they could best help their village if they built a healing centre.The healers and villagers got together to raise money to build it. They named it after one of their favourite village volunteers —The Memorial Of Mary Healing Centre or, the MOM-HC for short. It was the pride of the village — small, friendly, efficient and caring. Every year volunteers got together to canvass their neighbours to help with the cost of maintaining the MOM-HC. The centre was always open to new healers who wanted to join. In other parts of the kingdom new healers had to deposit gold into the Guild of Doctors (GOD as it was known elsewhere) before joining. In this village however, the healers decided that money should not be a prerequisite to join. Indeed, they often helped out a new recruit by using their own gold. Then one day a courtier from the castle came to town. He told everyone that the King had a good plan that would make life better for everyone. It was called the Village Insurance for Longevity for Everyone — the VILE Plan, for short. No longer would they have to pay their healers with chickens and eggs — the wealth of the whole kingdom would be shared to help all, even the country folk. As the seasons passed, the quality of life improved for both the villagers and the healing community. Babies were delivered, medical problems treated, operations performed. The local healers were often present, attending every stage of this life cycle, from the birthing room to the funeral home. They were there to guide their neighbours through the curing, caring and coping process. Then yet another “one day “ arrived. This time it was the Prince of Accounting who came. He lived in one of the towers in the castle and came down to tell the villagers that it was costing the kingdom too much to have babies in their village. “Babies are delivered better in the castle,” he declared. “Wouldn’t you want your babies delivered by those who do only that?” he asked them. The villagers reluctantly agreed, believing what was good for the babies was good for the whole village. Soon more princes came down to visit. The village was ecstatic. What attention was being poured on them! How special they must be in the eyes of the kingdom. Among the visiting dignitaries was the Prince of Management. He came to explain to the village elders, who were responsible for the healing centre, that he had a plan that would give them more time to work in their fields. This way they would be more productive. In one of the castle towers he was busy training people to organize and run healing centres. The MOM-HC, he declared, would have a revitalized name change. In order to make everyone feel they were being equally cared for, the name would be changed to the King’s Royal All Purpose Healing Centre — or, KRAP-HC, for short. While tending Off Call / Détente