The death of a young woman at a Denver specialty hospital has informed, yet complicated, the nation’s debate over health care.
The unfortunate accident that claimed the life of 25-year-old Hilary Carpenter at the Colorado Orthopaedic and Surgical Hospital ought to provide undeniable evidence of the need for greater transparency when it comes to the safety plans of these physician-owned facilities. If the hospital’s plan is to call 911 should something go awry, would-be patients deserve to know that.
But a larger fight over physicians referring their patients to their own doctor-owned hospitals is more complicated. A proposal in the health care reform bill that would prevent doctor-owned hospitals from collecting Medicare reimbursements seems counterproductive at this point. Congress would be acting too hastily if they passed regulations to stop or stall growth of these medical centers.
As in many specialty hospitals that focus on one or two disciplines, such as joint replacement, the fledging COSH facility lacks a full-scale emergency department. So when Carpenter was given an improper dose of pain medication, staff ultimately relied on a call to the general hospital across the street, St. Joseph.
Critics of doctor-owned specialty hospitals say laws ought to require greater transparency up front about plans for emergency situations. We agree. But critics also want to effectively kill specialty hospitals by banning doctors from referring their own patients to their facilities.
Such “self-referrals” are conflicts of interest, critics claim. Yet hospitals often own physician practices, and ask their doctors for referrals so the issue is hardly unique to specialty hospitals. Besides, shouldn’t our doctor be allowed to refer us where he or she wishes?
Still, it’s not so simple.
While it would seem the innovations and improvements that competition can bring would be good for all patients, specialty hospitals so far seem to relish the healthier and wealthier patients, and tend to focus on surgeries that are among the most reliable generators of revenue for general hospitals. If specialty centers are too successful, and too many patients with good insurance are siphoned off, general hospitals will suffer financially as they’re forced to continue to offer money-losing operations, such as emergency rooms.
Clearly, we don’t want to “save” specialty hospitals by “killing” our long-trusted community hospitals.
But with general hospitals making record-breaking profits, surely it’s too soon to call off the experiment of market-driven specialty hospitals.
