Critics are questioning whether the Philadelphia area really needs five transplant programs at area hospitals, saying that two transplant programs would be sufficient to serve the local market. When it comes to heart transplants, it's generally agreed that practice makes perfect-- and if five hospitals offer the procedure, the patient pool is spread thinly between transplant teams and reduces the amount of practice each gets. In 2005 only the Hospital of the University of Pennsylvania performed more than 13 transplant operations. Jefferson, Lankenau and Hahnemann conducted fewer than 12 heart transplants, which is the minimum number needed yearly for a hospital to qualify for Medicare funding. "Five programs is hard...it is not competition. It's just stupid," Abraham Shaked, a liver transplant surgeon and director of the Penn Transplant Center, told The Philadelphia Inquirer.

Hospitals feel they need to offer a full range of heart services in their cardiac centers in order to capture the profitable market, but this looks like a case in which less would be more. Pennsylvania enacted a certificate of need (CON) program in 1979 but it lapsed in 1996, which allowed a situation like this to arise. In April Rep. Phyllis Mundy (D) introduced a bill to bring back the CON program but the bill is currently stalled in the house because it doesn't have the support it needs. We all know what happens to transplant programs that can't get their act together, but analysts who've looked at the Philadelphia programs say things look fine for now. Only time will tell if the market can safely support all those transplant centers.

To get more information on the transplant market in Philly:
- read this report from the Philadelphia Inquirer