Thursday, March 31, 2005

HCA leads campaign to curb doctor-owned hospitals

An interesting article on the competition between physicians opening specialty hospitals owned by themselves and corporate medicine. Big-business medicine whines that physician-owned specialty centers gives physicians an "unfair advantage." I would classify this story under the heading "The World's Smallest Violin."

Big-business medicine claims physicians "cherry-pick" the best-insured patients for their centers. However, managed care and for-profits tend to try exactly the same thing to minimize care delivery, maximize corporate profit and shareholder value, and minimize physician income in the bargain to add insult to injury.

Businessmen need to realize that in essence, clinicians are the true owners of hospitals. As I've often said, in a somewhat tongue-in-cheek example, even if hospitals all burned to the ground in some hypothetical apocalypse, clinicians could still take care of patients to a good extent in tents using primitive equipment. They are enablers of healthcare; everyone else is a facilitator. (If only clinicians would become more politically astute and use this realization more aggressively.)

Dear HCA, welcome to the true marketplace of competition from those who actually know what they're doing in medicine, its practitioners.

-- SS

HCA leads campaign to curb doctor-owned hospitals (excerpts)
Staff Writer,

Before many of its heart surgeons left to become owners in a nearby specialty hospital, Oklahoma University Medical Center admitted 150 heart patients a month. Soon afterthe doctor's hospital opened, OU's cardiovascular admissions fell to zero.I t was a drop in business that has cost OU nearly $12 million since 2002 and threatened its ability to care for Oklahoma's most critically injured patients, OU's chief medical officer said. ''Simply put, these facilities drain essential resources from full-service community hospitals,'' said Dr. Andy Sullivan, chief medical officer of the OU Medical Center, a teaching hospital that operates under a joint agreement between the school, the state and Nashville-based HCA Inc.

HCA, which runs 190 hospitals in the United States and overseas, has become one of the leaders in the campaign to curb expansion of physician-owned specialty
hospitals across the country. ''This is a hugely important issue,'' HCA Senior Vice President Victor Campbell said.

What makes it important to companies such as HCA is that doctors are allowed to refer patients to facilities the doctors also own.Critics such as the American Hospital Association say this ''self-referral'' gives doctors an unfair advantage because they refer patients to their own hospitals and take the best-insured patients.

... But proponents of the hospitals dismiss such arguments as self-serving.''They bring competition to the community and bring a new way of thinking of health care,'' said Jim Grant, president of the American Surgical Hospital Association and a Nashville resident. ''They should be promoted.''

... Speaking recently before a House subcommittee looking at the issue of specialty hospitals, one AMA trustee said simply, ''Competition works.'' ''In the hospital industry, the addition of specialty hospitals to the mix gives patients more choice, forcing existing hospitals to innovate to keep patients coming to them,'' said the trustee, William Plested, a Santa Monica, Calif., heart surgeon who isn't affiliated with a specialty hospital.

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