A recent article in the New York Times noted a steady migration of doctors from private practice to hospital-owned health systems. The main driving force appears to be economic, that it is too difficult to run a business, especially when much of that entails fighting multiple insurance companies for reimbursement.
Some of the older physicians interviewed expressed “puzzlement” at younger doctors who chose salaried positions rather than private practice, with the suggestion that salaried doctors are somehow less committed.
When I chose to be a salaried physician after my training, I viewed it as a natural choice to express my commitment to medicine. After all, I wanted to practice medicine, not run a business. One beautiful thing about being salaried is that I have absolutely no financial conflict of interest with regard to my patients’ care. Nothing that I recommend or prescribe alters my income. This is very reassuring both to me and to my patients.
What intrigued me most in the article was the observation that “as doctors move from being employers to employees, their politics often take a leftward turn.” The article noted that the American Medical Association finally gave a “tepid” endorsement of the Obama healthcare reform.
With the shift toward the left among physicians, perhaps there will be a stronger momentum toward a single-payer-plan. Nearly the entire world has found this to be the most equitable way to deliver healthcare, to ensure that health care is available for everybody.
Only in America is health care a profit-driven enterprise. Though this may finally be changing.
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Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients.
View the YouTube book trailer.
You can follow Danielle on Twitter and Facebook, or visit her homepage.
Her blog, Medicine in Translation, appears on Psychology Today’s website.
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Kerry Lauerman
Joan Walsh
Salon.com
Comments
Peripherally, I noticed tonight that St. Vincent's went down.
For both of you - doctors here are mostly still private single-person practices. But the paper end of it here is much simpler and the single payer (government) simply pays submitted bills unless they look suspicious in some way.
(No need to say how much better it is for the patient, who can go to any doctor and who pays indirectly thru taxes, so that there is no medical insurance attached to jobs or that can be denied for pre-existing or bills that will bankrupt people, etc. etc.)
Finally, big hospitals are purchasing private practices, at huge prices, to control patients.