Mr. Ken Buckley of Ocean Grove has been a regular commenter on Blogfinger regarding healthcare issues. He sent us the comment below after watching a segment of “60 Minutes” where a large hospital corporation, abetted by some ER doctors, appeared to be churning admissions in order to make more money, without adequate attention to the best interests of the patients. My reply to him is below his remarks, and below that you will find the AMA code of ethics for physicians.
Paul,
After watching the Sunday night program “60 Mimutes” I feel you you may have to raise anew the role of the physician in controling healthcare costs. They interviewed doctors who worked at HMA hospitals who were held to meet admissions goals of 20% for emergency room patients and 50% for those 65 and older (Medicare pays for them.) Those ER doctors who did not comply and did the “right thing” were fired or moved to other positions. — Ken
Reply from Paul Goldfinger, MD, FACC:
Ken: I saw that program and I was as disturbed by that as you were. But, a Justice Department investigation is currently ongoing, so we can’t come to definite conclusions by watching that presentation. It does appear that this large hospital corporation was coercing its ER doctors to admit patients who didn’t require admission — all in the interest of profit. Some doctors were fired who did not comply.
If theses allegations are true, it will mostly be a case of corporate billing fraud. If any doctors are found guilty of intentionally admitting people who didn’t need hospitalization, then that needs to be addressed; whether the charge for them becomes bad ethics, fraud, or malpractice, I can’t say.
But, to your point about “raising anew the role of the physician in controlling healthcare costs,” I agree that ordering unnecessary tests and treatment by doctors in order to make money, usually in office settings, does occur and is a component of the “fraud and abuse” aspect of wasteful spending for healthcare. This physician component, along with bad behavior by hospitals, medical suppliers, pharmaceutical companies, healthcare providers of all types, malpractice lawyers, etc. does need to be addressed in trying to reduce healthcare costs.
You should know that proper behavior by physicians is guided by the profession’s ethics in addition to the rule of law. All physicians know that they should always place the best interest of their patients first and that they should, above all else, do no harm.