Regarding “'Roemer's law,' pro and CON”:

I read your recent article in Modern Physician and just wanted to make a few comments.

I had the privilege of being one of Dr. Milton Roemer's doctoral students, and took many of his courses during my master's of public health studies at the UCLA School of Public Health.

He and his wife, Ruth, were giants in the field of public health, Ruth in healthcare law, and Dr. Roemer notably in ambulatory-care administration and primary-care delivery from a national and international point of view.

His law that “if they build it, they will come,” about beds being filled was more true in the era of unbridled fee-for-service delivery mechanisms. However, with the growth of integrated systems working off of a prepaid HMO mindset, capitation or its variants, including bundling, I have seen hospitals and hospital systems scrap plans for adding beds. In fact, we have seen the contraction of beds at some very well-known university healthcare delivery systems.

Of course, certificate of need can be applied to various high-cost modalities as well (i.e. CT, MRI, PET), and perhaps have a place in the current market place, particularly where managed-care has not taken hold.

Thanks for the article.

Avram Kaplan, MPH
Laguna Hills, Calif.