Hospitals' acquisitions of physician practices will likely result in higher healthcare costs, reduced physician productivity and more fragmented care, according to an op-ed published in the Wall Street Journal.
Scott Gottlieb, MD, penned the op-ed. He is a resident fellow at the public policy think tank American Enterprise Institute, based in Washington, D.C. Dr. Gottlieb said President Barack Obama's healthcare reform law assumes models that worked well for certain large, integrated health systems will work elsewhere. But really, the law will "almost certainly make the practice of medicine more expensive," he wrote.
Based on the estimate that by 2014, 50 percent of U.S. physicians will work for a hospital or hospital-owned entity, Dr. Gottlieb said physician productivity is likely to take a fall.
"Once they work for hospitals, physicians change their behavior in two principal ways. Often they see fewer patients and perform fewer timely procedures. Continuity of care also declines, since a physician's responsibilities end when his shift is over," wrote Dr. Gottlieb.
He also said most hospitals exacerbate these strains by measuring productivity through Relative Value Units. "This system misses all of the intangible factors that help gauge the quality and efficiency of the care being delivered. It focuses physicians on the wrong goals for promoting health, such as how well they code charts to capture higher-value 'units,'" Dr. Gottlieb wrote.
He said hospitals often don't factor the possibility of reduced physician productivity into their acquisition strategies because "hospitals aren't buying doctors' practices because they want to reform the delivery of medical care. They are making these purchases to gain local market share and develop monopolies," according to the op-ed.
He also criticized how President Obama touts Danville, Pa.-based Geisinger Health System and Mayo Clinic in Rochester, Minn. "ObamaCare seeks to replicate these institutions nationwide, even though their successes had more to do with local traditions and superior management," wrote Dr. Gottlieb. "That's hard to engineer through legislation."
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Scott Gottlieb, MD, penned the op-ed. He is a resident fellow at the public policy think tank American Enterprise Institute, based in Washington, D.C. Dr. Gottlieb said President Barack Obama's healthcare reform law assumes models that worked well for certain large, integrated health systems will work elsewhere. But really, the law will "almost certainly make the practice of medicine more expensive," he wrote.
Based on the estimate that by 2014, 50 percent of U.S. physicians will work for a hospital or hospital-owned entity, Dr. Gottlieb said physician productivity is likely to take a fall.
"Once they work for hospitals, physicians change their behavior in two principal ways. Often they see fewer patients and perform fewer timely procedures. Continuity of care also declines, since a physician's responsibilities end when his shift is over," wrote Dr. Gottlieb.
He also said most hospitals exacerbate these strains by measuring productivity through Relative Value Units. "This system misses all of the intangible factors that help gauge the quality and efficiency of the care being delivered. It focuses physicians on the wrong goals for promoting health, such as how well they code charts to capture higher-value 'units,'" Dr. Gottlieb wrote.
He said hospitals often don't factor the possibility of reduced physician productivity into their acquisition strategies because "hospitals aren't buying doctors' practices because they want to reform the delivery of medical care. They are making these purchases to gain local market share and develop monopolies," according to the op-ed.
He also criticized how President Obama touts Danville, Pa.-based Geisinger Health System and Mayo Clinic in Rochester, Minn. "ObamaCare seeks to replicate these institutions nationwide, even though their successes had more to do with local traditions and superior management," wrote Dr. Gottlieb. "That's hard to engineer through legislation."
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