Friday, July 31, 2009

Physician owned hospitals - what a mess!

Interesting article with one theory about how health care in this country has been derailed.

Follow the link to the article by clicking on the title of this post.

Here are some excerpts:

"On May 15, a 25-year-old woman named Hilary Carpenter had an operation at the Colorado Orthopaedic and Surgical Hospital in Denver to replace a shunt valve in her brain. After the surgery, Carpenter experienced a severe headache and nausea. After consulting with a physician on duty, a registered nurse at the hospital administered Demerol, but the dosage was wrong, and Carpenter's heart stopped. In a scene that state investigators later described as "chaotic," hospital staff was unable to locate quickly the equipment needed to revive Carpenter. According to the investigators, there were only a few people on hand that day to deal with the crisis, and those present lacked training to handle such emergencies. Eventually the staff did something you wouldn't normally expect a hospital to do: They called 911. A paramedic team took Carpenter to a different hospital, where she died."

- Seems the hospital she was being treated in was a private, physician owned hospital and they did not have the staff nor the services required to treat such a serious situation. In fact, they are not required to as they typically try to avoid these types of cases....

More from the article:

"Doctor-owned hospitals are the most conspicuous manifestation of a culture of entrepreneurship that's gone a long way toward creating today's health care crisis. Although traditional economic theory holds that competition drives prices down, in medicine competition had tended to drive prices up as doctors explored new avenues for profit, most typically through fee-for-service overuse of expensive technologies and procedures. It's easy to shrug at such things and say, "That's capitalism." But, in fact, market-driven medicine didn't exist a generation ago, because the American Medical Association didn't allow it. "I saw it happen before my own eyes," says Dr. Arnold Relman, 86, emeritus professor at Harvard Medical School and former editor of the New England Journal of Medicine."

But, doesn't this completely go against the code of ethics of the AMA? One would think! There seems to be a serious conflict here.

What say you?

10 comments:

  1. What would the relevant part of the AMA's code of ethics be?

    ReplyDelete
  2. The AMA Code of Ethics can be found at:

    http://www.ama-assn.org/ama/no-index/physician-resources/2416.shtml

    Can't say I went through it, but it seems obvious that putting profit over patient welfare wouldn't be "covered." If that's what's happening in these hospitals, they would be one of a few contexts in which it does.

    ReplyDelete
  3. Not entirely unrelated....

    Medtronic CEO Got $8.9 Million In Compensation In Less Than Year On Job
    Medtronic’s CEO Bill Hawkins received $8.9 million in compensation in fiscal 2009. Hawkins took over as CEO last August and since then Medtronic has cut jobs and taken other steps to trim costs. A filing with the Securities and Exchange Commission showed his compensation included a $2.2 million performance bonus and $1.2 million in salary, plus stock worth $5.5 million.

    ReplyDelete
  4. Not all physician hospitals are in this category. The one in my city has a full service ED..AHA is publishing all this rhetoric, ignoring the published studies that show better quality, lower cost, and not taking away from acute care hospitals..

    ReplyDelete
  5. Just a note on blog etiquette – I would suggest not using the Anonymous moniker if possible. It becomes difficult to follow conversations if a number of people are using the same name. You can make up your own name and you’ll still be anonymous but at least different.

    Choose the Name/URL and make up a name, you don't have to list a URL. It will accept a blank.

    Thanks

    ReplyDelete
  6. Although the hospital typically tries to avoid such cases and, sadly, were not prepared for a life-threatening situation, doctors went ahead and performed brain surgery anyway.

    Did this happen in a small village in a 3rd world country? Oh, I'm sorry, you did say Colorado.

    ReplyDelete
  7. 100,000 PREVENTABLE deaths per year at hospitals nationwide. You single out a physician-owned hospital that, as a group, predominantly give better care than government-run or non-profits (as shown by various government studies). Get your facts straight people and don't run with a statistic of n=1.

    ReplyDelete
  8. The incident in Colorado is a one time occurence. This is not common for physician owned hospitals. Physician owned hospitals are some of the best in the country. Many people probably are not aware of this, but recently, US Centers for Medicare and Medicaid released data which exhibited notcieably better outcomes for patients at physician owned hospitals as opposed to those controlled by bureaucrats and corporations. Hopefully, negative attitudes and perceptions about physician owned hospitals will change in the near future, as this is a large part of the current healthcare reform debate that is occuring in our country.

    ReplyDelete
  9. Anonymous 1,2 and 3

    I guess it is fine to use anonymous as a moniker on this blog, but give us some information. Are you physicians who are part owners in a hospital?

    The questions was should doctors and other health care professionals for that matter, be allowed to be part owners in hospitals, and does this deviate from the spirit of the AMA guidelines. Is it completely ethical? What about doctors owning significant shares in medical device companies and pharmaceutical companies - is this ethical? Does it create a COI ( Conflict of interest?)

    Since some seem bound to only argue about the efficacy of these hospitals, consider the unfairness of the competition that the scenario of the physician owned hospital creates. It is known that these hospitals slough off the uninsured to the not for profit hospitals in the community, causing these hospitals to go deeper into debt - is this fair? No it isn't, these hospitals seem to specifically cater to citizens that are of a certain class, totally ignoring the 47 million un insured Americans - See the next article getting posted.

    ReplyDelete
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