Sunday, March 18, 2007

Boutique hospitals suck

A recent study published in JAMA indicates that specialty cardiac hospitals might be cathing everyone, whether they need it or not. They found that in areas where new hospitals opened, there were more revascularization procedures (CABG, PCI) than in areas where new cardiac programs opened at regular hospitals (thus it's not just the "if you build it, they will come" issue of adding resources to an area). Given the fact that these specialty hospitals are also exempt from the requirement that they provide emergency services (thus they don't have ER's and don't really benefit the community) and tend to skim well reimbursed patients from general hospitals (who are left with the expensive, uninsured, patients and less funding to provide care for them), this merely adds to my general hatred for these hospitals. That being said, my partial ownership of the local bariatric center has been very lucrative.

4 comments:

michael said...

This type of practice doesn't appeal to me either. However, I wonder why doctors should be forced to have artificial limits on their income imposed by arbitrary reimbursement set by insurance companies, or patients who have no insurance, or by any type of middleman at all. On one hand, those who try to make as much money as possible in today's market seem like scumbags, but at times they also seem like heroes. There is no reason why physicians should allow uninvolved parties to dictate their salary or level of service.

Garrett said...

Huh? Since when did suggesting that doctors should be discouraged from doing unnecessary procedures translate into outside parties limiting a physician's income?

michael said...

Well I guess I made a jump. I think doctors open boutique surgicenters and office practices because they aren't adequately compensated for doing things the right way. One aspect of the problem is that doctors feel it's part of the deal to make over 500k a year. The other part is that outside forces siphon funds, making doctors feel like unappreciated cogs in the wheel. I see surgicenters and boutique practices as attempts to bring empowerment back to physicians, even though in the short term it seems pretty douche-like.

Garrett said...

While physician empowerment is a nice idea, I'm pretty sure that allowing a select group to exploit the hell out of a broken reimbursement system isn't the way to improve physician empowerment.

It's nice to see philosophy-major Hong visit every once in a while :)