The answer to this question is not simple or black-and-white. In her book \u201cAmerican Sickness,\u201d Elizabeth Rosenthal, M.D. talks about \u201cthe transformation of American medicine in a little over a quarter century from a caring endeavor to the most profitable industry in the United States.\u201d Those who have lived in this area for a long time have witnessed this change in our valley. When I joined Glenwood Medical in 1973, Valley View Hospital was run by the Mennonite Board of Missions, had maybe 25 beds, and I was the 12th doctor on the medical staff. The doctors\u2019 wives helped cook the Christmas dinner for the hospital staff. There was a close relationship between physicians and the hospital, but physician practices were independent of the hospital.<\/p>\n
Part of the business plans of hospitals throughout the country now includes buying up physician practices. The majority of physicians in Glenwood work for VVH, and in Rifle most work for Grand River Hospital. On the positive side, the phenomenon of hospitals hiring physicians allows physicians to do what they like to do and what they do best \u2014 treat patients, without worrying about administrative duties. It also enables physicians who are struggling financially to stay in town, and provides them with benefits such as retirement plans and health care insurance.<\/p>\n
However, there can be downsides to hospital-owned medical practices:<\/p>\n
\u2022 At least for primary care doctors, there is built-in conflict of interest: Hospitals take care of sick people, and the job of PCPs is to keep their patients well and out of hospitals.<\/p>\n
\u2022 Almost always, lab and imaging studies in hospitals are more expensive than in free-standing facilities. Some (but not all) hospitals pressure their hired physicians to order lab and imaging from the hospital, which raises costs.<\/p>\n
\u2022 Some hospitals pressure their physician employees to refer patients to other physicians who work at that hospital, even though an outside consultant might be preferable.<\/p>\n
\u2022 Sometimes hospitals retain specialists such as orthopedists or neurosurgeons if they generate a lot of income for the hospital, even if they\u2019re incompetent or have other problems that affect their practice.<\/p>\n
\u2022 Rates for procedures such as upper endoscopies, colonoscopies, and many routine operations are almost always lower in free-standing outpatient facilities. Hospital-owned surgical providers often can\u2019t take advantage of this less-expensive alternative.<\/p>\n
\u2022 There are anti-trust legal concerns with doctor-hospital mergers. <\/p>\n
Martin Gaynor, a health care economist at Carnegie Mellon University, says that \u201call the evidence that we have so far\u2026indicated that these acquisitions tend to drive up prices, and there\u2019s other evidence that seems to indicate it doesn\u2019t do anything in terms of enhancing quality.\u201d A study of Medicare patients showed that the scenario of hospitals buying up physician practices \u201ccaused \u2026 health care services to rise $3.1 billion between 2012 and 2015, with beneficiaries facing $411 million more in financial responsibility for these services than they would have if they were performed in independent physicians\u2019 offices.\u201d<\/p>\n
Retired physician Greg Feinsinger, M.D., is author of new book \u201cEnjoy Optimal Health, 98 Health Tips From a Family Doctor,\u201d available on Amazon and in local bookstores. Profits go towards an endowment to the University of Colorado School of Medicine to add prevention and nutrition to the curriculum. He is available for free consultations about heart attack prevention, diabetes reversal, nutrition, and other health issues. Call 379-5718 for an appointment. For questions about his column, email gfeinsinger@comcast.net.<\/p>\n