Open Heart One Shots (Choices)

Residency Year 3 Starts...

OPH World Building

I've been reading about hospital and health system consolidation in recent years and that's a more likely scenario. So, I've come up with the following background for my stories in the latter half of Residency year 2, year 3 and beyond.

What does this mean?

Consolidation of Edenbrook and Mass Kenmore under a healthcare system/holding company. This is similar to what happened in real life with Mass General and Rush Medical in Illinois. Given how expensive healthcare is, it's becoming rare for hospitals in urban areas to remain fully independent; research shows that fewer healthcare systems owning a larger market share is the future.

Consolidation allows both hospitals to realize operational and cost efficiencies through shared services, make investments in healthcare technologies and research for better patient care, upgrade facilities, and negotiate better contracts due to economies of scale.

Both hospitals are run the way they are, but with changes to realize those efficiencies. For example, Mass Kenmore has a Level 1 Trauma Center, so they come first for major emergencies with Edenbrook taking on overflow.

Edenbrook is known for its excellent Residency program and its Diagnostics Team. So, Mass Kenmore's residency program becomes limited to specific specialities (like Trauma) and the Diagnostics teams get merged under Ethan Ramsey.

And yes, this means that Tobias Carrick will come to Edenbrook and join that team, and his reasons for why are consistent with what he shares in Book 3.

Edit: And no, Harper Emery doesn't join the Diagnostics Team because she's a surgeon and has no place on this team.

When does this happen?

I have a lot of experience with mergers and acquisitions and I know it can take up to 18 months with some changes implemented quickly and others taking time. So, let's say the consolidation is announced in February/March of second year. The changes start to take effect in June/July as third year begins, but don't actually get completed until September/October the following year (after OPH3 ends) at which point Ethan takes over as Chief of Medicine and Cassie as Head of Diagnostics.

Why am I doing this or even talking about it?

I do think that change is inevitable, so Edenbrook continuing on its path unchanged was not possible in the long term. As a writer (and reader), this background makes more sense to me and will give me opportunities to explore some of the big themes from Third Year, but without the whole Bloom drama, which was unnecessary.