Wednesday, September 30, 2009

The Cost of Care, Part 2

The second part of the Dallas Morning News’ five part series called “The Cost of Care” tackled the doctor-owned hospital dilemma. You can access the series here.

The article does a fantastic job of examining physician-owned hospitals from a variety of angles, admitting that it is a complex issue and that not all physician-owned facilities are created equal. We know that some physician/system partnerships provide much-needed services in a community in an efficient manner. However, we have also seen physician-owned facilities that duplicate services in order to cherry-pick paying patients from the community. These facilities have an Emergency Room in name only—usually a 10 x 10 space—in order to meet legal guidelines, but their main focus is making money, not caring for those in the community who may need it most.

What, then, are we to make of physician-owned hospitals? It is clear that this is an issue where we must tread lightly, examining all the facts before making judgments. While not all physician-owned hospitals exist solely to make money, we must be mindful of the conflict of interest self-referring may involve. It is sometimes hard to distinguish profit motives from patient motives when you are in the thick of things.

As the article points out, data on physician owned hospitals is hard to come by, but my anecdotal experiences with them run the gamut I expressed above. While I believe that all healers have as their highest goal the good of their patients, we have seen some of these hospitals that have positioned themselves to provide only “profitable” care for a small number of patients. We know that physicians must make a living, but doing so in a way that is not in the best interest of a community is immediately suspect.

So we move forward, aware of the pitfalls of and great services provided by physician-owned hospitals. We realize that they, like anything else in health care or life, must be approached with a healthy level of curiosity and—at times—skepticism. Above all, we must do what is best for those we treat, and ensure that our integrity can in no way be maligned as we go about our sacred work.

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