Looking for a great story about the state of hospital care in America? Look no further. The Health Care Blog has a great article by hospitalist Dr. Robert Wachter that sums it up nicely. It’s about money. Thats how hospitals get paid. That’s how everyone gets paid. It will always be about money. We don’t pay doctors, nurses, or administrators with smiley faces and candy canes. We pay them with cold hard cash. For example:
One of the physicians, an invasive cardiologist, stopped me in my tracks. “Actually, our hospital already provides a tremendous amount of support and feedback,” he said. “When I perform a catheterization or angioplasty, a hospital staff member watches the entire procedure, she sometimes suggests mid-course corrections, and as soon as I’m done she provides me detailed feedback on whether I met all the best practice standards.”
“Wow,” I said. “Your hospital is really taking quality seriously!”
“Oh,” he replied, mischievous smile on his face, “she’s not from the quality department. She’s from the billing department.”
The question should not be how do you get profit out of medicine. The question should be how do you get quality into profit. We need profit. The last thing you want in this country is universal VA health care. Trust me on that. Americans would never stand for it. But how do you get both?
Everyone will define quality differently. The only definition of quality that matters is the definition used by the one with the money. If you’re accepting third-party insurance money, their definition is all that matters. If you are a patient and you want quality care defined by your value system, you’ll have to pay for it out of your own pocket.
Now, if you have the money and influence, you can get the quality you want. If you’re poor, the quality you get is the quality that your insurance pays for. You’re going to have to live with that. It’s always going to be like that until the end of time.
*This blog post was originally published at The Happy Hospitalist*