Feature | June 22, 2006

Oh, What Tangled Webs We Weave...

Rick Dana Barlow, Editor

Imagine for a moment, if something along these lines actually had happened. Back in the early 1990s when the debut of the Internet’s World Wide Web empowered anyone to be a writer, reporter, editor or commentator, respectable print publications complained to the federal government about how this new medium was bad for competition. After all, it would likely reduce profits and revenues, which would drive many of the print media out of circulation and out of business.
Why? Because people could access all kinds of information – and as much as they could find since the information wouldn’t be limited to the number of pages supported by advertising and subscriptions – on just about anything at any time and anywhere they used an Internet-connected computer device. They no longer would have to wait two months, one month, one week or one day to read the latest gossip and news. How convenient, right?
So the print media posse petitions the feds to force the online media to attract a specific audience and charge print media-like fees for access and advertising so some semblance of parity is attained to level the playing field competitively. Ironically, that smells a bit like restraint of trade, doesn’t it?
Unfortunately, a similar philosophy infects the healthcare industry and has been simmering since the early 1970s. That’s when ambulatory surgery centers debuted as a cost effective and safe alternative to hospitals. Naturally, hospitals cried foul in this pre-DRG era because these new healthcare facilities were dangerous and attracted all the lucrative patients (those who need high-cost procedures and rely on sugar daddy private payers to foot the bills). Flash-forward to the DRG and post-DRG managed care eras when insurance companies and payers grabbed control of the healthcare system. You hear a similar hue and cry about the relatively new surgical hospitals, procedure-specific acute care facilities typically owned by doctors who don’t want to be fettered by hospital administration, finances and politics. Regular hospitals, standing near 6,000 strong and fronted by the mighty American Hospital Association, whine that this new player, squatting barely more than 100 strong, are stealing all the lucrative patients, leaving the regular hospitals with the spoils of charity care.
Actually, the arguments for and against surgical hospitals today, are nothing more than an evolution of the arguments for and against ASCs of yesterday. And the American Hospital Association, et. al., is returning the ASCs to the familiar hot seat by linking them up with their surgical hospital siblings. And it’s only a matter of time before this ekes into outpatient diagnostic imaging centers and cancer treatment/oncology centers. But it’s important to see this for what it really is: sour grapes. Nothing more. Sure, both sides will wrangle around detailed arguments on this esoteric point and that but what it really boils down to is this: Hospitals don’t want their status quo to be disrupted any more than the print media did. Too bad.
For the consumer, it’s all about choice. And consumers should have that choice. Unshackled by special interests. If hospitals are so worried about losing the lucrative patients to so-called profiteering doctors then they should improve their services – particularly customer service – to attract those patients to their facilities and away from the “new” competition. Pure and simple.
This is why hospitals are mired in the financial state they now enjoy. They spend too much time and energy whining and worrying about the other guy without taking responsibility for their own failures or the fickle public’s consistently changing interests and tastes. The name of the game is to disrupt or be disrupted. One philosophy can make you a winner; the other can break you. Choose wisely.
See you in 60.

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