In today’s world of healthcare, it’s no surprise that, at the end of the day, it’s a business. That is not a judgment – it’s a fact. And there is nothing wrong with that. What does get tricky is the incentives provided to those within the system, which influence provider behavior that ultimately affects patients and their potential health and wellness.
Here is an example: An anonymous physician posted on Kevin MDs website a short article titled: Health reform: Great for patients but this doctor lost his job. The core values of the physician’s employer are to promote human beings caring for other human beings, the creation of a healing environment for patients, their families and even staff members. Yet, behind all of that, it’s still a business and there was pressure to convert more office visits into surgical procedures potentially boosting the bottom line.
“Not everyone in this town needs surgery.” I get that ordering unnecessary tests and performing unneeded procedures might improve my current employment situation, but that would be unethical and horrible for the patients.”
While the physician’s employer didn’t directly say they needed to bring in more surgeries or order more tests, it is implied when their employer gave them six months to bring up their numbers and improve the practice financials.
Understandably, there are multiple things in play here: the person (aka patient), the physician treating the person, the hospital employing the physician who is treating the person and the overarching reimbursement system, which is paying the hospital to employ the physician who is treating the person. Each of these groups, at the surface, may have a similar goal of keeping people healthy and well; however, healthy and well people do not need to go to the hospital (that often anyway), and they don’t visit their physicians (that often anyway). So while the person may want better health – targeted reimbursement rates for certain visits and procedures for hospital and their employees (physicians) may provide conflicting incentives.
Being a business is not a bad thing, but being in the business of not caring for your customers’ needs is.