The Joint Commission on Accreditation of Healthcare Organizations is putting the hard sell on hospitals to buy its educational materials and services, and some hospital executives aren't thrilled.
Some are particularly bothered by JCAHO pitches to buy two books written by the wife of Dennis O'Leary, M.D., the organization's president.
In fact, some executives are coming forward with stories about getting the hard sell from accreditation surveyors, who are supposed to be peerlike consultants, not salespersons.
"The image of the once highly regarded accreditory body that was the Joint Commission as originally conceived has taken on the slick sheen of hucksterism," said an upstate New York hospital's quality assurance manager in an Aug. 26 letter to Daniel Sisto, president of the Healthcare Association of New York State.
MODERN HEALTHCARE obtained a copy of the letter and contacted the author. The author declined further comment and asked not to be identified but gave permission to excerpt the letter.
HANYS is reviewing the role of private accreditation in the state and is soliciting comments from its 210 hospital members (Aug. 8, p. 25). The HANYS board is expected to act on accreditation issues at a meeting later this year.
The issue of accreditation surveyors selling JCAHO products and services also came up at last month's annual American Hospital Association convention in Dallas.
During an open discussion with AHA President Richard Davidson, a hospital executive from Missouri said an accreditation surveyor told him to scrap his hospital's clinical outcome monitoring system and replace it with the JCAHO's clinical outcome monitoring system, known as the IMSystem.
Cathy Barry-Ipema, the JCAHO's communications director, said accreditation surveyors are not instructed to sell JCAHO products and services to healthcare facilities undergoing accreditation surveys. She said the commission has a marketing and sales staff to do that.
In fact, the JCAHO has just hired a new marketing director, a post that's been vacant since June 1993.
Ms. Barry-Ipema also said the fact that Margaret O'Leary, M.D., wife of Dr. Dennis O'Leary, authored two of the books being marketed by the JCAHO is "no secret." She's written four other books being sold by the JCAHO and is writing a seventh, Ms. Barry-Ipema said.
Dr. Margaret O'Leary, a board-certified emergency department physician, penned The Measurement Mandate: On the Road to Performance Improvement in Health Care, and Lexikon: A Dictionary of Health Care Terms, Organizations, and Acronyms for the Era of Reform.
The 1,200-page Lexikon sells for $90, and the 300-page The Measurement Mandate sells for $75.
Ms. Barry-Ipema said Dr. Margaret O'Leary receives a fixed payment for writing each book and is not paid any royalties based on book sales. To date, the payments have equaled about 5% of the total sales of her six books, she said.
The fact that the JCAHO president's wife authored several books being promoted by the JCAHO hasn't gone unnoticed by some hospital executives.
"The last physician surveyor to visit this hospital opened the morning conference with a sales pitch for a book written by Dennis O'Leary's wife," said the Aug. 26 letter to HANYS. "At a time when many hospitals are struggling just to maintain their physical plants, the JCAHO's in-your-face marketing of their pricey programs, books, videos, magazines...is particularly offensive."
In addition to conducting accreditation surveys, the JCAHO sells hundreds of educational books, videos and computer programs. It also conducts hundreds of educational seminars and conferences and operates a consulting subsidiary called Quality Healthcare Resources.
In 1992, the JCAHO generated about $17.9 million in revenues from the sale of publications, subscriptions and educational programs. That's up nearly 17% from publication and education revenues of $15.3 million in 1991, according to JCAHO tax records.
The 1992 revenues also represented about 26% of the JCAHO's total revenues of about $69 million that year.
Earlier this year, the JCAHO lost its property-tax exemption because local officials said it was acting more like a for-profit business than a tax-exempt public charity (July 25, p. 3). TheJCAHO's appeal of the tax decision is pending.