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No surprise there. Providing quality care is in direct contradiction with optimizing for profit. I think hospitals should only be allowed to operate as non-prof

by elteto 2y ago

No surprise there. Providing quality care is in direct contradiction with optimizing for profit. I think hospitals should only be allowed to operate as non-profits. With maybe some carve outs, but fundamentally be non-profits. Another problem is the large hospital conglomerates that end up owning all local hospitals in some areas. Large corporate structures always end up disconnected from reality and optimizing for the wrong things.

rqtwteye 2y ago
But not as non-profits as they exist right now. They are as greedy as for-profit with the only difference that the profits go to execs and their business friends and not to shareholders.
- chromatin 2y ago
  Physician-owned (even for-profit) hospitals historically provided the best care. The ACA ("Obamacare") outlawed new physician-owned hospitals. Now we find that PE-owned hospitals both cost more and provide worse care. Neither patient protection nor affordable care.
  - SkyPuncher 2y ago
    Physician owned was a joke of a marketing term. Physicians have the exact same incentives as business people - especially at a leadership level. It’s all about the money.
    - ProllyInfamous 2y ago
      >It’s all about the money. I think this is more about the retaliation of "having earned it/more," for all the decades of sacrifice becoming a thankless-physician entails. Money is a simple metric for simple people, but yes, absolutely it's about the money to a lot of people. I dropped out after the first year, because I realized I would self-delete (at some point) should I continue on the careerpath to physicianhood. I am so grateful to still be here, xx years later, doing anything else: If you want to help people and/or make lots of money, there are dozens of other career opportunities to do BOTH more-easily/better.
      - SkyPuncher 2y ago
        The thing is they types of physicians that become leaders at hospitals aren't the same ones who are in it "for the medicine". They're essentially MBA types with a medical degree. Many of them are largely removed from day-to-day medicine. I don't really mean this as a dig at them either. It's just the way of business. High level leadership takes a certain type of person to survive and thrive. This tends to be people who want to optimize the value of every hour they spend working.
        chromatin 2y ago
        I agree with a lot of what you've said. However, I know from experience these "MBA types with a medical degree" (why not "medical types with an MBA", btw?) don't stop caring about patients. Sure, there are a few who worship the almighty dollar above all else, but IME* a real concern for patients is still the foundation of their worldview. I will take a hospital run by business-minded physicians all day over a hospital run by business-minded ... businessmen. *source: am a physician

by elteto 2y ago

rqtwteye 2y ago

But not as non-profits as they exist right now. They are as greedy as for-profit with the only difference that the profits go to execs and their business friends and not to shareholders.

chromatin 2y ago
Physician-owned (even for-profit) hospitals historically provided the best care. The ACA ("Obamacare") outlawed new physician-owned hospitals. Now we find that PE-owned hospitals both cost more and provide worse care. Neither patient protection nor affordable care.
- SkyPuncher 2y ago
  Physician owned was a joke of a marketing term. Physicians have the exact same incentives as business people - especially at a leadership level. It’s all about the money.
  - ProllyInfamous 2y ago
    >It’s all about the money. I think this is more about the retaliation of "having earned it/more," for all the decades of sacrifice becoming a thankless-physician entails. Money is a simple metric for simple people, but yes, absolutely it's about the money to a lot of people. I dropped out after the first year, because I realized I would self-delete (at some point) should I continue on the careerpath to physicianhood. I am so grateful to still be here, xx years later, doing anything else: If you want to help people and/or make lots of money, there are dozens of other career opportunities to do BOTH more-easily/better.
    - SkyPuncher 2y ago
      The thing is they types of physicians that become leaders at hospitals aren't the same ones who are in it "for the medicine". They're essentially MBA types with a medical degree. Many of them are largely removed from day-to-day medicine. I don't really mean this as a dig at them either. It's just the way of business. High level leadership takes a certain type of person to survive and thrive. This tends to be people who want to optimize the value of every hour they spend working.
      - chromatin 2y ago
        I agree with a lot of what you've said. However, I know from experience these "MBA types with a medical degree" (why not "medical types with an MBA", btw?) don't stop caring about patients. Sure, there are a few who worship the almighty dollar above all else, but IME* a real concern for patients is still the foundation of their worldview. I will take a hospital run by business-minded physicians all day over a hospital run by business-minded ... businessmen. *source: am a physician