The public and the politicians may be missing the boat when they do not question the role of hospitals in the present health care debate. The hospitals have hung themselves out to be the “good guys” who hire and keep good doctors and promote the practice of good medicine. They portray themselves as the pillars of communities.
But in 1999, the Institute of Medicine reported that 98,000 deaths occurred in hospitals from medical errors. In 2016, the IOM said 250,000 deaths occurred in hospitals from medical errors. Are the people and lawmakers paying any attention to these numbers? I strongly suggest they read this article.
The fact of the matter is – hospitals are centers of huge corporate egos, greed, favoritism, and often poor patient care. Hospitals have become big and omnipotent – they have big lobbies and long hands.
CEOs make 4 to 5 million dollars a year. Several others in the upper management make some $1M per year. Is this morally congruent with the non-profit status of the hospitals? I don’t think so. The corporations do not have a spirit of altruism but still call themselves non-profit.
Each hospital has a few top dogs – the admin or the “suits” – with no heart and big egos. With a few handpicked members of the admin and doctors (a bunch of yes-men), they form the “inner sanctum.” They are the “good ole boys club.” They control everything – who practices in the hospital and how they practice. Their eye is on maximizing the bottom line – often unnecessary tests, procedures, and surgery, sometimes leading to a botched surgery that nobody speaks out against. Most doctors nowadays are directly hired by the hospital and are only too eager to please the admin and inclined to look the other way when something bad is happening. Once this mafioso system with a pack mentality is set up, the hospitals do whatever they bloody well please. The gravy train is on!
If a new (independent thinking) doctor comes in and is not liked by the admin because he is competing with the hospital group or is of the wrong ethnicity, they all gang up and start throwing mud at him. They label him “not a team player,” his practice “bad medicine,” etc. They use the “peer review” system to accomplish their nefarious goals.
In an honest peer review system, colleagues critique each other honestly and honestly. They learn from each other’s mistakes. These concepts have no meaning in the corporate environment where everybody is a corporate cog in the wheel. The hospital handpicks the “peer reviewers,” and they follow the admin’s agenda.
If one of “their own” makes a mistake or exercises poor judgment, nobody criticizes him or her because nobody wants to incur the wrath of the admin. But any independent-minded doctors are quashed by the admin using this system. The records of the “peer review” system are not discoverable in the courts. This is a sweetheart deal and allows the hospitals to cover up grave mistakes of “their own” and throw under the bus good docs they don’t care for.
The hospital and its docs have free play to practice whatever they want and make as much money off the public as they want. They do everything in the most expansive, esoteric, and exorbitant way. They also injure and kill many patients because there is effectively no audit of their poor practice of medicine. Bad docs who are favorites of the admin stay and good docs are kicked out.
Ron Virmani is an obstetrician-gynecologist.
