I don't have the time or background to explore this topic in any amount of depth, though it is an extremely important one. I thought of it when I heard the term "wallet biopsy," a procedure done to see whether a patient is eligible for an expensive treatment or health insurance.
Hospitals are businesses. They need to make money to stay afloat. There isn't a way around it. The people that run a hospital and manage it are concerned with the bottom line. They are not doctors, they're businessmen. However, revenue isn't guaranteed. Some patients can't pay, some insurance companies won't pay. Yet the service we provide can't be negotiated. If a motorcyclist gets in an accident, he needs a CT regardless of financial situation. The hospital may or may not be reimbursed, but the man is dying; the physician isn't thinking about money, until he gets slapped on the wrist by the hospital administrators. Restaurants reserve the right to refuse service to anyone. At some level, hospitals relinquish that right.
How do we reconcile finances with health care, especially in this age of defensive medicine (which I may address in the future)? Who makes the final decisions? I really think clinicians should call the shots about what a patient needs. If I'm ever in a place where some guy with an MBA and without an inkling of medicine tells me what I can and cannot do for my patients, things need to change.
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4 comments:
Your posts are always thought-provoking. :) It's a zero-sum economy, however, so someone has to pay for that CT scan. Who can it be?
wow, was that from
http://fingersandtubesineveryorifice.blogspot.com/
haha yes, this thought occurred to me when i read fingers&tubes
Right on, you tell that MBA to buzz off!!
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