Doctor’s Diary April 11, 2018: Here’s the game plan

(Snippets from the frontline)

Here’s the game plan

Hospitals are integral to the health and vitality of a community, and often serve as the difference between life and death.

In the past, some hospitals faced difficult financial times including bankruptcy.  Business interests came to their aid, but developed a game plan to fill personal  pocketbooks.

The bulk of hospital payments (like Medicare and Medicaid) are “bundled” for each admission with a flat fee payed for all medical services.  Substantial profits could therefore be gained by making a quick diagnosis, then shuffling the patient to a nursing home (SNF) to complete treatment that used to be done in the hospital.

But doctor medical decision-making had to be controlled.  So as physicians became hospital employees or signed contracts, they were financially threatened by administrators if they did not jettison patients toward a SNF.

Now, the difference a hospital serves between life and death is swayed away from the practice of good medicine to those seeking to fill their pocketbooks.

It will be up to patients and public advocates to alter the game plan.

Gene Uzawa Dorio, M.D.