We have an expression in our Chicago newsroom, and the version I can repeat goes like this: Everyone is an art director. Designing each issue of Modern Healthcare is the most subjective function we perform each week. And virtually every reporter and editor on staff thinks they know best when it comes to performing that function. Not everyone can report, write or edit, but everyone knows where a photo should be placed on a page. They just can't agree on where. Of course, I'm the only person who really knows.
A similar phenomenon is occurring in the healthcare industry. Everyone thinks they can do everyone else's job better. As much as we're in favor of competition in healthcare, this may be when competition often becomes foolishness. A number of stories in last week's issue document the I-know-better-than-you trend.
Reporters Michael Romano and Laura B. Benko wrote about three deals announced in early June in which hospitals or systems intend to buy physician group practices (June 13, p. 4). The buyers are Tufts-New England Medical Center in Boston, the two-hospital TriHealth system in Cincinnati and John Muir-Mount Diablo Health System in Walnut Creek, Calif. In pursuit of increased patient referrals for inpatient care, these hospital systems decided they know how to operate physician practices better than the physicians who owned them.
As Romano pointed out in an earlier story (Jan. 3, p. 8), the systems are just three of many hospitals or hospital systems that are revisiting the physician practice-acquisition strategy-a strategy that crashed and burned in the 1990s. The strategy failed because many physicians just didn't seem to work as hard for their new hospital owners as they did when they were working for themselves. What's going to change this time around? We're not sure. Hospitals say they'll now be more informed and selective buyers rather than blindly gobbling up any practice in sight lest it falls into the hands of a competitor.
In the same issue, Romano and reporter Vince Galloro wrote about two separate deals also announced in early June in which physicians would buy hospitals (p. 8). In the first, a group of about 100 physicians wants to buy two hospitals on the island of Oahu from St. Francis Healthcare System of Hawaii, Honolulu. In the second, a group of about 15 physicians wants to buy Southwest Hospital & Medical Center in Atlanta.
It's one thing for a physician to have staff privileges at a hospital or to be employed there. It's another for a physician to manage a hospital as either a board member or chief executive officer. But owning a general acute-care hospital and one that's struggling financially to boot? That's a headache like no other, and we're not sure physicians have enough aspirin, let alone enough capital. Regardless, the trend of physicians trying to save their dying hospitals by owning them is picking up steam, as we noted in a cover story earlier this year (Jan. 17, p. 8).
In this week's issue, we have a special report on two famed healthcare economists and academics serving on the boards of hospital systems (p. 26). Are they good board members? Or do they know too much about how the healthcare system works to be of any practical use? One thing is for sure, the CEOs of those systems can't pull any fast ones at their board meetings.
Much of this reminds us of the late 1980s, when many hospitals thought they could run their own health insurance companies better than the insurers themselves. Most failed miserably at it and were out of the underwriting business by 2000. As a side note, this is what I find particularly annoying about hospitals opposing physician-owned specialty hospitals. It was OK for hospitals to go into another line of business, but it's not OK for physicians to do the same thing. Seems a bit hypocritical.
Anyway, maybe the healthcare delivery system in the U.S. would be a lot better off if everyone just stuck to what they were supposed to do rather than trying to do the other guy's job all the time. Or if they do, they better be damn good at it. Is my photo centered?