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Bedpan Alley thrown a curve ball as new technology changes medical landscape

New York City’s hospital-heavy arteries — long-dubbed bedpan alley — have been thrown a curve ball by the changing medical landscape.

While hospitals across the country have been embracing downsizing, the Big Apple is just getting in the game, according to experts.

Last month’s announcement that Beth Israel, which has been open since 1929, will close its Union Square building on 16th Street and First Avenue as part of a major reconfiguration to create small, hyper-local facilities, was a surprise to many.

But it wasn’t a surprise for Joe Lhota, the former deputy mayor and MTA chairman who ran for mayor in 2013 and who is now the senior vice president, vice dean, and chief of staff at NYU Langone Medical Center.

Lhota recently spoke about the changing hospital landscape  at a real estate conference in Brooklyn, and said it’s an issue that needs to be understood more clearly.

“Ten years ago, when this all began, the Berger Commission said we have too many hospital beds in New York and it was extremely controversial because, at the same time, they weren’t explaining how health care was changing,” said Lhota at TerraCRG’s “Only Brooklyn” conference June 1.

Pictured l-r at the TerraCRG Only Brooklyn conference are l-r: Carlo A. Scissura, president and CEO of the Brooklyn Chamber of Commerce; Joe Lhota; Lorraine Grillo, NYC school construction authority; Tucker Reed, president of the Downtown Brooklyn Partnership
Pictured L-R at the TerraCRG Only Brooklyn conference are: Carlo A. Scissura, Brooklyn Chamber of Commerce; Joe Lhota; Lorraine Grillo, NY SCA; and Tucker Reed, Downtown Brooklyn Partnership

In 2006, The Berger Commission released a report recommending the state close nine hospitals and reconfigure 48 others. The move would reduce the number of hospital beds by 4,200, or around seven percent of the state’s total supply.

The report stated the reason for the closures and reconfigurations was an “unacceptably high excess capacity” of hospital beds, which they estimated at more than 10,000 hospital beds. Most significantly, the report noted that the statewide hospital occupancy rate had fallen from 83 percent of certified beds in 1983 to 65 percent in 2004.

“These declining occupancy rates are driven in part by significant changes in where and how people get medical care,” read the report. Fast forward ten years, and the story remains the same — how and where people get medical care has changed significantly, and that’s mainly due to the advancement of healthcare technology.

“The healthcare industry needs to explain what’s going on, and elected officials need to understand that a bed isn’t the thing that it used to be,” said Lhota.


“You can have an ambulatory surgery facility in a neighborhood and be able to get the high quality healthcare that you need.”

He gave the example of a double hernia surgery, a common procedure that ten years ago, would have required a one to two-night hospital stay.

Now, because of advanced technology and the ability to to have “targeted surgery,” an individual can be in for the surgery at 9 a.m. and leave to go home at 5 p.m. the same night.

It’s not just Mt. Sinai and the Beth Israel downsizing – many other hospital chain’s in NYC are making big changes to their facilities, downsizing larger hospital buildings and looking for new facilities in neighborhoods.

At NYU Langone, 34 percent of the hospital’s patients come from Brooklyn, and according to Lhota, they do more outpatient surgery than any other hospital in NYC.

“Pretty soon you’re not going to have to go to Manhattan to have surgery, they’ll go to our site in Cobble Hill, or NYU Lutheran, or other ambulatory surgery places being built in Brooklyn,” said Lhota.

“Why hassle going to Manhattan if you can do it right here in your own borough, that’s the direction healthcare is going.”

Lhota said hospital chains will be looking for sites for new ambulatory surgery facilities that look “very different” from hospitals while being just as efficient, and they’ll look for convenient transportation and good housing nearby.

“New York is one of the last places in the country to realize this, that beds aren’t needed anymore,” he said.

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