Healthcare infrastructure is every bit as important as education and transportation, in a county growing as quickly as Loudoun, where citizens worry both about their proximity to the nation's capital in an era of national disasters and about receiving emergency services quickly when their son or daughter is seriously injured at a sports event.

Rapid growth in Loudoun has put the county way behind the national average in available hospital beds. Today Loudoun offers only .7 hospital beds-per-thousand residents when the national average is 1.4 hospital-beds-per-thousand.

Why, then, is HCA, the nation's largest healthcare provider, being met with such resistance about building a second hospital in Loudoun County?

Because healthcare is an afterthought until we need it according to HCA Capital Division President Margaret Lewis.

"Healthcare simply isn't top-of-mind until you need it," Lewis explained.

"No one likes to focus on negative things, even though concern about being able to help our families and friends is very much in the back of our minds. As soon as Loudoun citizens understand that a new HCA hospital will increase the care they receive, I am certain we will be breaking ground for our new facility."

Lewis recently moved from Richmond to Northern Virginia to lead HCA's Capital Division. She is a 30-year veteran of HCA, and who completed all of her three degrees with help from HCA.

"I started as a nursing assistant and, within 26 years, I was CEO," she said.

"My career at HCA speaks highly for the caliber of this company from bedside to boardroom, and I use my clinical background and my understanding of the basic fundamentals of nursing every single day.

"For HCA, its all about the patient. It's about quickly assessing the need, coming up with a workable plan and delivering the service that is needed, she emphasizes.

Lewis, who describes herself as a poster child for the junior college system across the Commonwealth, works diligently today to help those institutions continue to serve dedicated individuals who simply would not get ahead without a loyal employer and an education system that provides services to part-time students.

In addition to better medical services, economic development also depends on a robust healthcare system.

"I've been speaking to Loudoun business leaders, and they understand that we're an important part of the economic engine of the county," Lewis continued. "When a region is being surveyed as a potential site for a new business, public health and safety are major elements in the decision making. The quality and quantity of jobs being brought to Loudoun will be affected by the healthcare services offered in the county."

Hospitals and Homeland Security

Hospitals are also the primary destination in any type of disaster whether that be weather or terrorist related.

As the largest healthcare system in the country, HCA's resources were seriously tested during Hurricane Katrina. Tulane University Hospital, an HCA facility, eventually had to evacuate all patients, and did so by using their national network to bring in 24 Black Hawk helicopters that landed on the top deck of the facility which had been readied for choppers.

"After we took care of our own patients and people, we pitched in to help our competition," Lewis said. "We have the benefit of a very large network of hospitals and staff we can dispatch from all over the country to focus on an area in need. We consistently dispatch clinical and human resource staff immediately to any point in the country that needs help in an emergency."

Because HCA has a large network of hospitals in Florida, the organization has a deep understanding of and response strategy for emergency situations. Response to weather-related disasters are simply part of the rigorous training and planning that every hospital in the network offers the communities they serve.

"Sadly, we have lots of experience with disasters, and we are now very well organized across the country for an avian flu epidemic," according to Lewis. "Our headquarters team in Richmond trains just as diligently as our local facility teams because we know that leadership is as important as staff on the ground in an emergency."

"We also have tremendous surge capacity to ensure that our communities receive prompt and efficient care no matter what the situation."

If competition raises the bar for better services and lowers the costs across the board, how long does Lewis think it will take for their new Broadlands facility to be up and running?

"Once we receive the certificate of need, we'll begin to build," she says.

"Because initial resistance was ferocious from the monopoly provider, many citizens were afraid we would simply leave. That's not going to happen.

"We have made a commitment to Loudoun County and we are going to keep it," Lewis concludes. "There are counties in Virginia, like Henrico near Richmond, that have three hospitals and 955 beds. Loudoun has one hospital with 167 beds to serve the fastest-growing county in the country. This doesn't make sense to me, and I'm certain it doesn't make sense to parents and citizens."