Regarding your cover story on the orthopedic kickback settlement (Extended warranties, Oct. 8, p. 6): Having been in healthcare administrative roles for years, both in the ambulatory medical office and acute inpatient settings, I have long been bothered and intrigued by the squeeze that is placed on the middle guy (the hospital) by device vendors and physicians. I think hospitals need to get out of the middle of the purchasing and let vendors negotiate and sell directly to the practitioner. It would be the physicians responsibility to choose the best product, inform/educate their patient consumer and bill/collect for the device. There would certainly be little money lost by most hospitals with the continued lack of standardization of product use by physicians and potentially more choice for some docs and patients with direct vendor negotiations.
Pam CronrathDirector Acute-care services St. Francis Hospital Federal Way, Wash.