Inside the Health-Care Crucible

➔Inquirer staff writer Michael Vitez, embedded in Abington Memorial Hospital, is writing a series of occasional articles from the front lines of America’s health-care system.

Reports from a hospital in a time of upheaval

Abington Health and Holy Redeemer Health System called off their plans for a merger Wednesday, amid intense pressure from activists...
When you are a patient in a hospital - in this case, the cardiovascular unit on the fifth floor of the Lenfest Pavilion at Abington...
The top two executives at Abington Memorial Hospital called the health-care bill that passed the House yesterday a necessary first...
On the evening of Jan. 3, Fran Bogom, 86, a resident of the Abramson Center for Jewish Life in Horsham, was sitting on her bed...
First in an occasional series. Mary Tole, 74, a vibrant, independent woman until last spring, lay in an intensive care bed at...
Randy Klein had a lovely vacation, three weeks in Europe with her husband, Stephen, for their 36th anniversary. They went to Paris...
Prince Pulido loved his mother. She named him Prince, after all. And he couldn't let her go. It didn't matter to him that nurses...
Eliahna Riley Silva was born at 10:50 a.m. April 18, weighing one pound and 3.7 ounces. Evan Edward Obert-Thorn arrived six hours...
One in an occasional series. All his professional life, Steve Moriconi, an oral surgeon with a private practice in Jenkintown...
After 25 years as a family physician, the joy of medicine was gone for Joseph Mambu. He'd spent 22 years in a practice big into...
One in an occasional series. When the afternoon sunlight streamed in her hospital window, slashing through the venetian blinds...
One in an occasional series. Catherine "Pat" Zakrzewski of Roxborough was her family's matriarch, hosting 90 people...

About this Series


Reporter Michael Vitez set out with an ambitious assignment. He wanted to embed himself at an American hospital and look at health reform from the front line of U.S. health care. It was the fall of 2009, and the nation was consumed with the debate over health reform.
 
Vitez wanted to look at what life was like inside the hospital - to show  how things worked, and how things might change if health reform is truly implemented. He wanted to show why some reforms were needed.
 
His first challenge was getting the leaders of Abington Memorial Hospital in Montgomery County to trust him and the Philadelphia Inquirer enough to offer relatively free rein. There were privacy rights of patients to protect, federal confidentiality laws to contend with. But Abington's leaders prided themselves on transparency, and Vitez operated under a golden rule: he wouldn't write about patients unless they or their loved ones consented.
 
The second challenge was getting patients to agree. That still left a big question: What to write about? Vitez, a master of the sweet story, could have written daily articles about heroic doctors and remarkable recoveries. But his goal was to look at issues, problems and challenges, to tell narratives that would not only be great yarns but would offer a window into a world that most people have rarely if ever visited.
 
So he looked at palliative care, and how it had been tarred by the brush of death panels, and how it could be both a solution at the end of life to excessive and unwanted treatments and immense economic cost to the system. He followed a pioneer of a new model of care, the patient-centered medical home, and tried to explain how that concept could also improve care and reduce costs. He examined a 45-year-old Medicare regulation that put hospitals and patients in a precarious situation, and the economic and policy justification for it as explained by the federal government. And so on.
 
In a five-part series in 1997, Vitez chronicled how critically ill patients and their families confronted death. The series, "Final Choices," won a Pulitzer Prize and generated intense debate and reader interest.
 
This new series, "Inside the Health-Care Crucible," has also sparked considerable reader response. And the stories are still coming.