One of These Docs Is Doing Her Own Thing

And it’s working. Dr. Patricia Gabow’s remarkable turnaround of Denver Health has made it a national model for public hospitals. And it just may be a blueprint for health care in the United States.

Whenever you hear about Denver Health, it’s almost always in news akin to these actual press snippets from last year (cue AM radio reporter voice): “Denver’s first homicide of 2010 took place at 3:11 a.m. at 1434 South Lipan St. Police were summoned to break up a fight and found a man who was not breathing. The victim, whose identity was not released, was taken to Denver Health Medical Center….” “The other driver was transported to Denver Health Medical Center for treatment of non-life-threatening injuries. He has been identified as Jose Nevarez-Coronado, 22. He was later arrested on suspicion of vehicular homicide, driving under the influence and….” “A second man, who police were calling a suspect in the homicide, walked into the emergency room at Denver Health Medical Center a short time later with a gunshot wound.…”

And so it’s always been. 1860: Honest Abe is president. It’s two years after the Pikes Peak Gold Rush—16 years before Colorado is officially a state—when Dr. John F. Hamilton and Dr. O.D. Cass open the first city hospital of Denver, the place a noble mess of good intentions from the start. Patients tend to be “bummers,” which means some variation of the ornery types who’d come to strike it rich, but who more often than yelling “Eureka!” ended up broke, drunk, and trying to fight or fornicate away their misery—and thereby ended up shot, stabbed, or otherwise torn asunder by syphilis.

In 1873, long after Dr. Hamilton had left to patch up Union soldiers in the Civil War, Dr. John Elsner persuaded Denver and Arapahoe county commissioners to fund the construction and operation of a new City Hospital at the location where its descendent Denver Health stands today. That newly erected hospital was still regarded as the “Poor House” or “Almshouse.” Even then, it was apparent that combining health care and politics was a bad prescription. Throughout the 1900s—and most pronounced under Mayor Benjamin Stapleton—Denver’s City Hospital, like so many city agencies in so many cities, became a municipal swamp of patronage and corruption. During the two decades Stapleton was in office, he infamously stacked the hospital decks for everyone from custodians on up.

So it went, for decades—until Mayor Wellington Webb was elected. It was 1991, and Denver General Hospital was hurting. All of the worst aspects of being a city agency were crippling the hospital’s performance. “We felt we were being constrained by the city,” says Dr. Ernest “Gene” Moore, who has been at the hospital since 1976 and is one of the most renowned trauma surgeons in the country. “Abiding the rules that the city had us operating under, I think all of us felt like we couldn’t function the way we needed to.

“For starters,” Moore says, “we were under the city’s civil service regulations. If you had a clerk on the floor or a secretary who was rude or didn’t do their job, you could never fire anybody. Endless appeals. It was like, once hired, on for life. We took on dead weight to the point it was ridiculous. Purchasing new equipment would take years. All of the bidding and committees downtown…. The City Manager of Health and Safety [who oversaw the hospital] wouldn’t have a clue.”

That first year of Webb’s administration, Denver General was operating at a $38 million deficit, and there was talk of it going under. Webb was determined to not let that happen. The first African-American mayor of Denver, Webb was born on the working-poor South Side of Chicago in the Cook County Hospital. He was a sickly kid with asthma so severe his parents sent him to Denver to live with his grandmother, and his grandmother took him to Denver General. As mayor, Webb would not forget what it was like to be among the city’s most vulnerable population and need a public hospital. On top of that, Webb wanted a legacy of having built things, like Denver International Airport, Coors Field, the Colorado Convention Center. He did not want to be remembered as the mayor who closed down the then 130-year-old public hospital.

And along came this little lady doctor at Denver General. She was relentlessly tugging on Webb’s pant leg and telling him he ought to give up control of the hospital. Just give it up. To her. Dr. Patti Gabow insisted she could not only save the hospital, but she could also make it a model public hospital.