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Physician-Owned Hospitals: Preventive Medicine Instead?

With the new healthcare reform bill signed into law, the fate of physician-owned hospitals was sealed:

The bill Congress passed in March includes a ban on new physician-owned hospitals and freezes those already in business at their present size. Doctors hold a one-third interest in Avera Heart, which opened in 2001, so the bill President Obama signed would prevent that facility from ever growing.

The law change, in effect, leaves expansion of treatment of cardiovascular disease open for Sanford to dominate locally in coming years — if in fact that field of medicine grows. Avera Heart says such growth is not a given, because people are living healthier and have less need for emergency care. (Argus Leader)

While it’s easy to point to the potential conflict of interest inherent to physician-owned medical facilities, it’s not so easy to demonstrate that non-physician-owned hospitals don’t have similar conflicts with generating profits. After all, continuing to build large $78 million expansions requires hospitals of any kind to achieve a return on their investment in order to continue operations.

So with the downturn in heart attacks that we’re now seeing thanks to public health initiatives like anti-smoking campaigns, how is Sanford going to fund their shiny new facility?

Why prevention, of course!

O’Brien acknowledges the down trend in heart attacks but said other needs are increasing. Sanford performed 20,000 heart screenings the past two years, and about 1,000 led to follow-up such as a stent procedure to clear a passageway for blood flow. In the past, many such problems would show up later as a heart attack.

“We see fewer heart attacks than we did in previous years, but more can be done without resorting to surgery,” he said. “Across the country surgery numbers are down, and angioplasty and stent numbers are up.” (Editor’s note: So much for having the COURAGE to say “no,” eh? Let’s not forget the conflicts inherent to physicians being employees of hospitals who increasingly tie physician compensation to their productivity.) (Argus Leader)
On the surface, prevention sounds sexy as a cure-all for our current healthcare cost conundrum. What’s not to like with preventing disease before it happens? But to think the hospital administrators have patients best interests at heart by using prevention as their excuse to “screen” for more heart disease, we should ask ourselves if the non-physician hospitals are any more altruistic than partially physician-owned facilities:

“You don’t build cath labs and surgical suites if you’re going to do preventive medicine.”

Amen.

But then, our congressmen understood all this, right?

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*


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