I find it almost laughable that there are folks in Washington that think all physician-owned facilities are the bad guys in this melodrama and that wiping them out would solve the healthcare crisis. It would be laughable if it were not so dangerous.
We trust physicians to make life and death decisions on a daily basis for their patients. Studies have shown that upward of 92% of the Medicaid population treated by physician owners are done in their own facilities. Many times the other 8% are taken to the hospital because of other factors in the patients medical history, not because physician-owned facilities are doing wallet biopsies. A surgery center cannot provide services for a patient with an American Society of Anesthesiologists score of 4 and higher because it is not safe to perform the surgery in the ASC setting. The patient is more likely to need inpatient hospitalization than is a patient with an ASA score of 1. Medicare frowns on physicians performing an outpatient procedure knowing that the patient is highly likely to be transferred to an acute facility for inpatient services because of the underlying medical condition of the patient.
While there are physician-owned facilities that meet the description of a villain, the vast majority do not. Hospitals missed the industrial revolution, if you will. Hospitals do not need to be all things to all people any more. Does General Motors manufacture their own tires? No, they obtain them from other suppliers.
Quality studies have shown that specialty hospitals have better outcomes in terms of infections rates, etc., than do the general hospitals. Patients have shorter stays and better results for the most part. Access to care is enhanced not diminished. Will increasing access to care improve the overall healthcare of the country or will it decrease healthcare? The answer is obvious to all but those outside of the system who think they know better.
Stuart Katz, F.A.C.H.E., C.A.S.C.Executive directorTucson Orthopaedic Surgery CenterTucson
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