Having lived in the west county for many years, we are saddened to see the closure of Palm Drive Hospital. Our families have received excellent care from the great staff there and we will always be grateful.

As members of the first Palm Drive Health Care District board, we are also grateful to the current board members who, faced with a complex and difficult situation, have made the decision to take steps to close the hospital.

The health care marketplace is changing and consolidating. Small, local hospitals like ours just can't compete for patients with the larger hospitals — rich in resources and able, with their higher patient volumes, to survive in the changing health care environment. And, though many of us might prefer to use Palm Drive for our hospital care, that often isn't an option based on the insurance we have.

Thus, the hospital census has continued to drop and revenues to fall, leaving Palm Drive heavily in debt.

The focus of health care is changing. Medical professionals and insurers (including government) are looking for better ways to achieve good health.

While hospitals will always play an important role in the health system, the emphasis and investment in health care today is shifting away from expensive tertiary care to less costly and more cost-effective approaches like primary care, outpatient services, community-based care and prevention.

So now we, as a community, have some decisions to make. With the Palm Drive board's help, we need to come together and consider our options. We have to focus our attention on determining what kinds of services does our community need now and in the future?

We need to listen carefully to the community, look for successful models in other communities and seek out expertise that can help us create a new vision.

We believe Palm Drive has a future and that there are many kinds of services that could be offered that would be of tremendous benefit to the west county, including urgent care, diagnostics, outpatient procedures, chronic disease management, physical therapy, hospice, senior services, behavioral health and many others.

We also have confidence that the Palm Drive board, with the help of the community, can assemble a plan for a package of health services that will meet the needs of the community and keep the health care district in the black; a package of services that will be utilized and valued by the people who live in our district.

Palm Drive is a tremendous community asset that we can use to improve the health and well-being for everyone in the west county. That's a future we can all believe in.

<i>Barbara Graves is retired director of prevention and planning division with the county Department of Health Services. Mary Szecsey is executive director of West County Health Centers.</i>