We trust physicians to make life-and-death decisions on a daily basis for their patients. Studies have shown that upward of 92 percent of the Medicaid population treated by physician owners are done in their own facilities. Oftentimes the other 8 percent are taken to the hospital because of other factors in the patient’s 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 four 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 one. 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’s.
While there may be some physician-owned facilities that meet the description of a "villain," the vast majority do not. Hospitals have missed the industrial revolution, if you will. Hospitals do not need to be all things to all people any more. Does General Motors manufacture its own tires? No; it obtains them from other suppliers. I am of the opinion that physician-ownership should be done in cooperation with a local community hospital unless the hospital is unwilling to cooperate. Many hospital administrators have failed to realize that physicians are not the enemy but, if they were to engage the physicians and align some of the incentives, conquering many of our crises could occur. We are fortunate here in Tucson that our hospital partner recognizes this valuable relationship and has endeavored to make the bonds stronger between it and its medical staff.
Quality studies have shown that specialty hospitals have better outcomes in terms of infections rates and other quality measures 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, FACHE, CASC
Executive Director
Tucson Orthopaedic Surgery Center
skatz@tucsonortho.com
