PHARMACIST STEVE

A university hospital system in Philadelphia, PA, has recently announced the closure of its pain management practices. While specific details about this particular closure were not found in the search results, it is part of a broader trend where large hospital systems are shutting down specialty practices or entire departments focused on single diseases or services.

According to Becker’s Hospital Review, since mid-2023, dozens of hospitals across the U.S. have announced closures or reductions in specialty departments or single-service units. These closures span a wide range of specialties including labor and delivery services, behavioral health units, pediatric units, dialysis clinics, urgent care centers, oncology services, and more. For example:

• Multiple hospitals have closed or are closing labor and delivery departments due to declining birth rates and staffing shortages (e.g., ThedaCare Medical Center Waupaca in Wisconsin, MaineHealth Waldo Hospital, Mayo Clinic Health System in Minnesota, and others)23.

• Behavioral health units have been shut down in some hospitals due to financial and operational challenges (e.g., Mercy Fitzgerald Hospital in Pennsylvania, St. Dominic Health Services in Mississippi)23.

• Pediatric units and specialty clinics such as pediatric cardiology have also been closed in response to low patient volumes and workforce shortages (e.g., Sentara RMH Medical Center in Virginia, PeaceHealth in Washington)23.

• Other specialty services like dialysis clinics, urgent care centers, and oncology/radiation therapy services have been terminated or scaled back in various health systems23.

Overall, Becker’s reported at least 41 department closures or service terminations since July 2023, and a total of 72 such closures or endings since early 2023. These closures are driven by factors including declining patient volumes, workforce shortages, financial pressures, shifting patient preferences (e.g., telehealth), and changes in community health needs23.

In 2025, hospital closures and service consolidations continue, with entire hospitals shutting down or converting to outpatient-only models, further impacting specialty care availability4.

In summary, the closure of a pain management specialty practice in Philadelphia fits into a larger national pattern where large hospital systems are shutting down or scaling back single-disease or specialty-focused practices due to evolving healthcare demands, financial challenges, and workforce issues. At least dozens of such specialty units have been closed or announced for closure across the U.S. in recent years, affecting a variety of specialties beyond pain management234.

It is not typical for regional healthcare systems to fully expand and seamlessly absorb all patients in need of specialty care after the closure of single-disease or specialty practices. Instead, the reality is often more complex, with significant gaps in access to care for affected patients.

What Usually Happens After Specialty Practice Closures

1. Increased Strain on Remaining Providers

• When specialty services close, remaining hospitals and clinics-especially safety-net providers-often experience a surge in patient volume. This can overwhelm already strained resources, leading to longer wait times, delays in care, and in some cases, decreased quality of care49.

2. Limited Expansion by Regional Systems

• While some regional healthcare systems attempt to adjust by taking on additional patients, this expansion is usually reactive and limited by capacity constraints. For example, after service reductions at a major hospital in Santa Clara County, local county hospitals anticipated significant strain and the need for major adjustments, but also expressed concern about being able to meet increased demand49.

3. Vulnerable Populations Are Disproportionately Affected

• The negative effects of specialty care closures are most pronounced among low-income, uninsured, elderly, and rural populations. These groups face increased travel times, higher out-of-pocket costs, and may forego care entirely due to inconvenience or lack of access68.

4. Emerging Solutions-But Not Yet Widespread

• Some health systems are piloting innovative approaches to expand specialty care access, such as:

  • Training primary care physicians (PCPs) to provide certain specialty services.

  • Using telemedicine to connect patients with distant specialists.

  • Coordinating specialist referral networks for underserved patients1.

• However, these solutions are not universally adopted and often depend on local resources, disease burden, and institutional priorities1.

5. Fragmented and Delayed Care

• Closures often result in more fragmented care, with patients shifting between providers and experiencing longer delays before receiving needed specialty services. This can lead to worse health outcomes, especially for those with complex or chronic conditions239.

Are Patients “Abandoned”?

While some regional systems make efforts to absorb displaced patients, many are left with reduced or delayed access to the specialty care they need. In practice, the transition is rarely seamless, and significant numbers of patients-especially in underserved communities-experience barriers to care, increased travel, and sometimes abandonment if no alternatives are available4689.

Summary Table

In summary, while there are efforts to expand access after specialty practice closures, it is not typical for regional healthcare systems to fully and effectively absorb all affected patients. Many experience reduced access, longer wait times, and, in some cases, are left without the specialty care they need149.