The Business of Health Care Depends on Exploiting Doctors and Nurses

Danielle Ofri, June 8, 2019 (Dr. Ofri practices at Bellevue Hospital in New York, and wrote this essay for The New York Times)

You are at your daughter’s recital and you get a call that your elderly patient’s son needs to talk to you urgently. A colleague has a family emergency and the hospital needs you to work a double shift. Your patient’s M.R.I. isn’t covered and the only option is for you to call the insurance company and argue it out. You’re only allotted 15 minutes for a visit, but your patient’s medical needs require 45.

These quandaries are standard issue for doctors and nurses. Luckily, the response is usually standard issue as well: An overwhelming majority do the right thing for their patients, even at a high personal cost.

It is true that health care has become corporatized to an almost unrecognizable degree. But it is also true that most clinicians remain committed to the ethics that brought them into the field in the first place. This makes the hospital an inspiring place to work.

Increasingly, though, I’ve come to the uncomfortable realization that this ethic that I hold so dear is being cynically manipulated. By now, corporate medicine has milked just about all the “efficiency” it can out of the system. With mergers and streamlining, it has pushed the productivity numbers about as far as they can go. But one resource that seems endless — and free — is the professional ethic of medical staff members.

This ethic holds the entire enterprise together. If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous. Doctors and nurses know this, which is why they don’t shirk. The system knows it, too, and takes advantage.

Emphasis added. Click here to read the full article. (It may require a subscription.)

Death at birth. The Commonwealth Fund reports: U.S. Women More Likely to Die in Pregnancy and Childbirth and Skip Care Because of Costs Click here. Dec. 19, 2018—A new Commonwealth Fund report out today contains troubling news about the state of women's health and health care in the United States, with many of the problems linked to issues of affordability.

Could You Be Forced to Pay Mom's Nursing Home Bill? - Click here. July 2012. Next Avenue

Why Oregonians want a Better Health Care System. Click here. 9-13-17 Mike Huntington MD

Inequality and the health-care system in the USA. Click here. April 8, 2017, Woolhandler et. al. The Lancet.

Bill of the Month, Rabies Treatment After Cat Bite, Shots: Click here. - Feb. 26, 2019 Health News : NPR.

I Went to the Dentist Today, Click here. Feb. 22, 2019. Daily KOS. A story of unnecessary pain and cost in the US health care system—contrasted with German system.