Physicians provide the counterpoint when hospitals too tempted by profits

LETTER — Posted May 24, 2004

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Regarding "Med-staff hospital fights turn nasty and more litigious," (Article, April 19): I am encouraged to see physicians taking a stand in this struggle for power. The tail has been wagging the dog for too long. The "business end" of medicine should always function in the service of the patient.

Although it is true that health care facilities must be fiscally sound in order to provide quality care, there must be vigorous advocacy for quality, regardless of the expense, to serve as a counterpoint to the temptation to cut staff and services to protect the bottom line. This is most at risk in facilities owned by public corporations where the first priority is the value of the stock.

If we lose control of credentialing, peer review and medical staff bylaws, facilities are free to consider a doctor's value in terms of the amount of income he or she can generate rather than how well the patient is treated.

In my specialty, I have seen psychiatrists carry 20, 30 or more patients in the hospital and spend less than two minutes per patient on rounds. These are the "heavy admitters" courted by local facilities. But are they providing quality assessment and care?

As physicians we abdicate our moral responsibility to the patient when we delegate too much authority to the administration of the facilities we use.

It takes time and effort to participate in this dialogue, and sometimes it means that we have to rock the boat, but unless we are content to just be used by corporate medicine as a commodity, it is a necessary struggle.

Elizabeth C. Henderson, MD, Ridgeland, Miss.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/05/24/edlt0524.htm.

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