One of the goals of this blog is to provide physician insight into some of the top media healthcare stories in order to help patients and consumers make informed decisions. However, sometimes there are important stories that don't gain a lot of attention, that should also be pointed out.
One such story is a recent report in the Washington Post regarding physician owned hospitals and how they were poorly able to handle emergencies. The report stated that only about half of the 109 physician owned hospitals they surveyed had emergency rooms, and those that did were barely adequate. About one third of the hospitals studied called 911 when there was an emergency. Certainly, at face value, this report call into question the capability of such hospitals to provide adequate care in the event of an emergency. It also add fuel to those against physician owned hospitals who worry that "doctors who own hospitals are more likely to refer patients to those hospitals, have an incentive to put profits above the patient's health." However, in my opinion the importance of the story is that it exemplifies how having 47 million Americans without health insurance potentially affects the health care for those with coverage.
Proponents of physician owned hospitals claim that they offer high-quality specialized care by focusing on certain groups of patients. However, these groups of patients tend to be the most profitable to treat, such as orthopedics and cardiac care. But another advantages that physician owned hospitals have is that they aren't required to have an emergency room. A private practice in the outpatient setting or a privately owned hospital can refuse care to any patient they want. However, once you put up a sign that says "emergency room," you are legally obligated to treat that patient, regardless of who they are or more importantly their ability to pay. There are also laws in place that prevent hositals from diverting patients who can't pay to other hospitals. Thus, hospitals have to eat the cost of patients without insurance, and that loss usually is passed on to patients with insurance. Why to you think the hospital charges $5 a pill for Tyelenol?
But hospitals also make up for this loss by providing some of the more lucrative services for covered patients such as orthopedics and cardiac care. If physician owned hospitals start providing these services alone, and start taking away this business from the city and community hospitals, these hospitals will not be able to survive. Many will close. This means that even if you have excellent health insurance, therer might not be an adequate number of hosptials with emergency services when you need it the most!
One solution could be to require any physician owned hospital to have emergency room services, but the recent study shows that even those that had them were inadequate. The real solution is finding health care coverage for everyone.