Let's think about care priorities …
There's no surprise. Isn't this the all-too transparent and unspoken reason why the California Medical Association and the Texas Medical Association are fighting tooth and nail to keep the so-called threat of "corporate practice of medicine" from cutting into profit margins of their members? The corporations (hospitals) are evil, while father knows best. And anyway, why ever would we want rural and underserved-area hospitals finally being able to hire physicians where there are too few providers? I doubt the urban areas would even notice if the folks who drive many hours to see them stopped coming and stayed local, except, perhaps, if they were getting an unneeded arthroscopic knee surgery, a carpal tunnel release, or rotator cuff repair—just a few of the cash cows of urban medicine. Never mind that they can't get diabetes, hypertension and oncology care where they live.
John Rochat, M.D.Hematology & Oncology ClinicAnticoagulation Clinic Mendocino Coast District HospitalFort Bragg, Calif.
... and care about patterns of behavior
As a physician-misbehavior researcher, I can assure you there is nothing new in these findings, although it is excellent to see previous studies supported by more recent evaluations. Unfortunately, medicine as carried out in our country is by and large fertile ground for dishonesty, outright theft, fraud and considerably worse. During the past nine years, I have accumulated well more than 11,000 cases of serious physician misbehavior, and often the more outrageous antics, such as those described in the article, come about after years of "entitlement" mentality. Regardless of where one sits on the national healthcare debacle, the sad fact is no one on either side is willing to admit that 50 physicians each and every week of the year are found guilty of serious misbehavior. No other profession in America comes close to these appalling numbers, and the disease process—as is so often the case—often starts "small," as in the inherent conflict of interest in a physician referring patients to his own specialty service. Regretfully, physicians as a group have managed to bring much of the wrath of outside discipline on themselves. It didn't have to be this way.
K. Patrick McDonaldConsultant, speaker and authorRedlands, Calif.