What you (and many physicians, unfortunately) don't get is that it is horrible for many people to make the trip to a facility in a city or even a bigger town. Many 80 year olds will tell you, "I'd rather be treated by people I know in our 25-bed hospital than to have to drive into a larger town, any day of the week." Others will say, "I'd rather die than go to a large hospital." That's a fact.