Princess Health and Support for the "Endangered Primary Care MD". Princessiccia

Princess Health and Support for the "Endangered Primary Care MD". Princessiccia

physicians primary care

Gusty 11:07 Add Comment

An op-ed piece in the Boston Globe by Ellen Lutch Bender, the Director of Health Care Strategies for the law firm Brown Rudnick, entitled "The Endangered Primary Care MD," speaks to the adverse consequences of the dominance of health care by ever larger organizations.
Lutch Bender extolled the virtues of primary care doctors whose ideal is "providing care within a patient-physician relationship based on understanding, honesty, and trust." Furthermore, she suggested that the decline in primary care relates to "consolidation [which] has created a concentration of giant market participants whose dominance has decreased competition." As a result, primary care doctors "spend so much time on paperwork that their ability to care for patients is strained. They work at a frenetic pace from dawn to duskc, seing more patients, faster, to meet productivity benchmarks. They operate in a resource-constrained environment that has skyrocketed the cost of managing their practice and racheted down their incomes." Sound familiar?
She concluded that "this trend has serious ramifications, not only to cost and quality of care but also in the potential loss of the heart and soul of the medical profession."
It seems like more and more people are noticing the issues that Health Care Renewal has been bringing up.
...if only they had some solutions to these problems. Unfortunately, Lutch Bender's suggested approach was pretty opaque, "there is enormous opportunity for physicians to think differently and seek innovative alliances with other providers in a way that will spur competition for those courageous and committed enough to protect the relationship between physicians and their patients." Hopefully, she will come up with something more concrete in the future.

Princess Health and Support for the "Endangered Primary Care MD".Princessiccia

Princess Health and Support for the "Endangered Primary Care MD".Princessiccia

physicians primary care

Gusty 11:07 Add Comment

An op-ed piece in the Boston Globe by Ellen Lutch Bender, the Director of Health Care Strategies for the law firm Brown Rudnick, entitled "The Endangered Primary Care MD," speaks to the adverse consequences of the dominance of health care by ever larger organizations.
Lutch Bender extolled the virtues of primary care doctors whose ideal is "providing care within a patient-physician relationship based on understanding, honesty, and trust." Furthermore, she suggested that the decline in primary care relates to "consolidation [which] has created a concentration of giant market participants whose dominance has decreased competition." As a result, primary care doctors "spend so much time on paperwork that their ability to care for patients is strained. They work at a frenetic pace from dawn to duskc, seing more patients, faster, to meet productivity benchmarks. They operate in a resource-constrained environment that has skyrocketed the cost of managing their practice and racheted down their incomes." Sound familiar?
She concluded that "this trend has serious ramifications, not only to cost and quality of care but also in the potential loss of the heart and soul of the medical profession."
It seems like more and more people are noticing the issues that Health Care Renewal has been bringing up.
...if only they had some solutions to these problems. Unfortunately, Lutch Bender's suggested approach was pretty opaque, "there is enormous opportunity for physicians to think differently and seek innovative alliances with other providers in a way that will spur competition for those courageous and committed enough to protect the relationship between physicians and their patients." Hopefully, she will come up with something more concrete in the future.

Princess Health and Comments by Jacobi Hospital's Former Executive Director: "I Feel Really Good". Princessiccia

Princess Health and Comments by Jacobi Hospital's Former Executive Director: "I Feel Really Good". Princessiccia

Jacobi Hospital Mismanagement

Gusty 13:48 Add Comment

The Executive Director of Jacobi Hospital, who was fired because the hospital failed to notify hundreds of women about concerning Pap test results, had these comments for New York Post reporters:

• "I feel good. Everything is wonderful. I feel really good."

When asked if he wished to apologize to the women who were not informed of their abnormal test results, he referred the question to the New York Health and Hospitals Corporation, and slammed the door.
Another example of a hospital leader showing real concern about quality of care, and the concerns of his institution's patients - not.

Princess Health and Comments by Jacobi Hospital's Former Executive Director: "I Feel Really Good".Princessiccia

Princess Health and Comments by Jacobi Hospital's Former Executive Director: "I Feel Really Good".Princessiccia

Jacobi Hospital Mismanagement

Gusty 13:48 Add Comment

The Executive Director of Jacobi Hospital, who was fired because the hospital failed to notify hundreds of women about concerning Pap test results, had these comments for New York Post reporters:

• "I feel good. Everything is wonderful. I feel really good."

When asked if he wished to apologize to the women who were not informed of their abnormal test results, he referred the question to the New York Health and Hospitals Corporation, and slammed the door.
Another example of a hospital leader showing real concern about quality of care, and the concerns of his institution's patients - not.

Princess Health and Secret Hospital "List Prices" Revealed in San Jose. Princessiccia

Princess Health and Secret Hospital "List Prices" Revealed in San Jose. Princessiccia

health care prices hospitals

Gusty 13:12 Add Comment

A real health care market would require we have informed consumers who can make rational decisions. We have shown how some hospitals seem to be using marketing to undermine their patients' rational decision making. Meanwhile, patients are often completely in the dark about how much hospitals charge for their services.
A new California law has forced hospitals to disclose previously secret "list prices" for health care services. The San Jose Mercury News reports how hospitals in the San Jose area have wildly varying list prices for the same services:

• Comprehensive metabolic panel (blood test), $149 to $520
• One-day medical surgical stay, $1909 to $3900
• Screening mammogram, $95 to $405

At least one hospital spokesperson was frank about the lack of relationship between "list prices" and actual costs. Jan Emerson, a spokesperson for the California Hospital Association, stated "There's zero connection between costs, charges, and reimbursements. In many cases, to get $5 more from the health plans you have to raise your charges $50 or more."
The hospitals may be using inflated prices as a tool to extract more reimbursement from managed care organizations and insurance companies. These "list prices," however, are not without consequences for patients.
While insurance companies or managed care organizations usually pay just a fraction of these "list prices," the uninsured, who are often poor, may be charged the full prices, and may or may not easily obtain discounts. The article included the anecdote of an uninsured waiter who was charged a total of $43,000 by a not-for-profit hospital and his surgeon for an appendectomy. The hospital later offered him a discounted charge of $21,000, but this was still too much for him to afford. We have posted other examples of hospitals charging the uninsured their full, often stratospheric "rack rates." (Also see this post.)
The article noted that Medicare and managed care organizations often make their reimbursements functions of the "list prices," providing an inducement for hospitals to raise these prices as high as they can.
This last point is important. One would think that managed care organizations, which have been promoted primarily because of their ability to control costs, might have some idea what reasonable reimbursement might be for common health care services, regardless of how high hospitals set their "list prices." However, they seem to think they are getting a good deal if they can achieve a certain percentage discount from whatever the hospital charges, no matter how high it is. (Recall an earlier example of UnitedHealth being willing to reimburse a Tenet hospital $1275 after the hospital charged $2713 for a one-hour physical therapy evaluation session. Presumably this kind of astute bargaining is why the CEO of United Health Group got over $124 million in total compensation in 2004.)
In summary, although a true market for health care requires that consumers have complete pricing information, hospitals have traditionally kept the prices of their services secret. Furthermore, their list prices often seem wildly inflated, because managed care organizations think they are getting a good deal if they can reduce the list prices by what appears to them to be a large proportion. These organizations, who advertise themselves as rational agents of cost-control, seem clueless about how hospitals have manipulated their simplistic schemes to discount their charges.
This is another argument for physicians assuming the role of watchdogs on behalf of their patients, guarding them against the incompetence and self-interest of powerful health care organizations.

Princess Health and Secret Hospital "List Prices" Revealed in San Jose.Princessiccia

Princess Health and Secret Hospital "List Prices" Revealed in San Jose.Princessiccia

health care prices hospitals

Gusty 13:12 Add Comment

A real health care market would require we have informed consumers who can make rational decisions. We have shown how some hospitals seem to be using marketing to undermine their patients' rational decision making. Meanwhile, patients are often completely in the dark about how much hospitals charge for their services.
A new California law has forced hospitals to disclose previously secret "list prices" for health care services. The San Jose Mercury News reports how hospitals in the San Jose area have wildly varying list prices for the same services:

• Comprehensive metabolic panel (blood test), $149 to $520
• One-day medical surgical stay, $1909 to $3900
• Screening mammogram, $95 to $405

At least one hospital spokesperson was frank about the lack of relationship between "list prices" and actual costs. Jan Emerson, a spokesperson for the California Hospital Association, stated "There's zero connection between costs, charges, and reimbursements. In many cases, to get $5 more from the health plans you have to raise your charges $50 or more."
The hospitals may be using inflated prices as a tool to extract more reimbursement from managed care organizations and insurance companies. These "list prices," however, are not without consequences for patients.
While insurance companies or managed care organizations usually pay just a fraction of these "list prices," the uninsured, who are often poor, may be charged the full prices, and may or may not easily obtain discounts. The article included the anecdote of an uninsured waiter who was charged a total of $43,000 by a not-for-profit hospital and his surgeon for an appendectomy. The hospital later offered him a discounted charge of $21,000, but this was still too much for him to afford. We have posted other examples of hospitals charging the uninsured their full, often stratospheric "rack rates." (Also see this post.)
The article noted that Medicare and managed care organizations often make their reimbursements functions of the "list prices," providing an inducement for hospitals to raise these prices as high as they can.
This last point is important. One would think that managed care organizations, which have been promoted primarily because of their ability to control costs, might have some idea what reasonable reimbursement might be for common health care services, regardless of how high hospitals set their "list prices." However, they seem to think they are getting a good deal if they can achieve a certain percentage discount from whatever the hospital charges, no matter how high it is. (Recall an earlier example of UnitedHealth being willing to reimburse a Tenet hospital $1275 after the hospital charged $2713 for a one-hour physical therapy evaluation session. Presumably this kind of astute bargaining is why the CEO of United Health Group got over $124 million in total compensation in 2004.)
In summary, although a true market for health care requires that consumers have complete pricing information, hospitals have traditionally kept the prices of their services secret. Furthermore, their list prices often seem wildly inflated, because managed care organizations think they are getting a good deal if they can reduce the list prices by what appears to them to be a large proportion. These organizations, who advertise themselves as rational agents of cost-control, seem clueless about how hospitals have manipulated their simplistic schemes to discount their charges.
This is another argument for physicians assuming the role of watchdogs on behalf of their patients, guarding them against the incompetence and self-interest of powerful health care organizations.

Princess Health and Detroit Hospitals' Advertising War. Princessiccia

Princess Health and Detroit Hospitals' Advertising War. Princessiccia

deception hospitals marketing

Gusty 12:51 Add Comment

Although pharmaceutical companies have been rightly criticized for pushing marketing rather than science, they are not the only health care organizations that may do so.
The Detroit News reports on an advertising war being waged by area hospitals. What's notable is how some hospitals, as the paper put it, "say hawking hospital services is no different than selling cola or a car." (The quote is of the article, but was not attributed to a particular person by the reporter.)
In particular, Beaumont Hospital has pursued an advertising campaign to get patients to pick a Beaumont doctor. Its web-site has a pop-up that flashes, "Are you at risk for a heart attack? Do you have a Beaumont doctor?"
Beaumont Director of Marketing and Public Affairs Michael Killian defended the campaign, first noting that patients still need to check out their doctors themselves, "Patients ought to ask every question they can, probe into everything that worries them." But he justified the "foreboding" advertising by saying that connecting with patients emotionally is necessary to get them to seek needed care, "People don't make decisions based on fact. They make decisions based on feeling. If you don't connect with somebody emotionally, you don't connect."
Emotional appeals are unlikely to create better informed patients. Cynically advocating decision making based on emotions may bring in more money, but is unlikely to inspire better decision making.
As I stated in my comment below, physicians need to become watchdogs with loud barks and sharp teeth who will protect patients against all kinds of exploitation by all kinds of powerful health care organizations.