The current issue of Health Affairs is a special edition on the eroding relationships between many hospitals and physicians. Here's an excerpt from the lead article, out of the Center for Studying Health System Change in Washington.
"Because many services performed in hospitals can safely and conveniently be performed in ambulatory settings, physicians have become owners of entities directly competing with hospitals for patients in a new medical arms race. Hospitals and medical staff physicians face growing tensions as a result of physicians' growing reluctance to take emergency department call and the consequences of hospitalists replacing physicians in the care of inpatients. Although there are increasing expectations that health system challenges will lead hospitals and physicians to collaborate, in many markets the willingness and ability for hospitals and physicians to work together is actually eroding.
...A major source of wasted spending lies in unwarranted intensity of hospital and physician services, particularly for patients in their last months of life. Yet instead of working together to address excessive health care spending, physicians and hospitals have renewed a "medical arms race" that is driving up costs even faster, sometimes as collaborators but increasingly as competitors.
The health care system has relied on hospitals to serve as providers of last resort for uninsured patients with emergencies. Hospitals in turn have relied on community physicians to be on call to their EDs. But that reliance is now called into question as even more insured and uninsured patients seek care in EDs that have problems assuring physician coverage."
Not a pretty picture and not one most health care consumers are aware of. This is an issue that should be explored in the mainstream news media.
Posted by schwitz at December 5, 2006 09:24 AM | TrackBack