The politics of corporate medicine has replaced helping patients

It was a particularly challenging case.  On the car ride into the hospital, I found myself doing something that I rarely do.  I called a local allergist for an inpatient consult.  Most allergy issues are not an emergency.  So it is odd indeed to summon this particular kind of physician into the medical wards.  His nurse took the message and promised that she would plug my mobile number into his pager.

A few minutes later we were discussing the particulars of the case.  He was excited by the details.  This was something that he had only seen a few times in his career.  He rattled off a number of questions and I answered them to the best of my ability.  I was standing in the hospital lobby by now. I didn’t want to risk venturing up to the patient room for fear of losing my mobile connection in the stairwell.

I was about to give the floor and room number when the allergist interrupted me with an unexpected question.

“Do you work for the medical group?”

He was referring to the large hospital based practice that had recently bought up almost all other physicians in the area.  I knew that he had joined them, but generally don’t consider such alignments when making decisions about who to consult on a particular case.  I always try to call the best physician for the job regardless of who they work for.  I paused for a moment before telling him that I was still part of an independent practice.  Although I could sense the hesitation in his voice, I would have never in a lifetime expected what came out of his mouth next.

“Oh, um, sorry, I only do inpatient consults for physicians who are part of the medical group.”

It was such an abrupt surprise, I hung up the phone dumbfounded before thinking of the litany of questions that were now pummeling through my head.  Since when does the politics of corporate medicine replace helping those in need?

I’m sounding the death knell.

The primacy of patients in our health care system has now ended.

Jordan Grumet is an internal medicine physician and founder, CrisisMD.  He blogs at In My Humble Opinion.

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  • southerndoc1

    If the hospital-owned group is prohibiting their serfs, I mean doctors, from consulting on other patients in-house, sounds like an anti-trust violation . . .

    • Deceased MD

      Good thought. But I wonder if this pt even knows what happened. But eventually one day with enough of this going on, some lawyers will make a killing.

  • Dr. Drake Ramoray

    I’m a bit surprised (not that there are are politics in inpatient care) but that the medical by-laws at your hospital allow this. At one job I actually gave up my Endocrinology privileges because I would get called with every single patient who had diabetes (controlled or not) sometimes on the day of discharge at 10:30 in the morning while I had a full day at the office. I was told by the powers that be that if I got a consult I had to see it regardless of any other factors. I didn’t stay long after I gave up hospital privileges but if I was this author I would have to find out.

    If it is in the hospital by laws then it’s time to look for another job +- going to the press about it. Start thinking of moving elsewhere now (if you wish to provide inpatient services) because if your hospital will do this it will be a terrible place to work if it comes to that.

    • Deceased MD

      Hospitals use doctors like kentucky horse farms use race horses. That is the most ludicrous rule. That hospital lost one good doctor in you!

  • Deceased MD

    This is a wonderful example of how there is increased morbidity and mortality. This is not from any official study. Just from opening my eyes.

  • Dr. Drake Ramoray

    Insurance companies, hospitals, government, even our organizations and societies. Doctors are surrounded by enemies.

  • SarahJ89

    It ended years ago in my area. The local suburban hospital fancies itself a “regional health care facility” and has bought up all practices within a 30-mile radius. They have a cyber wall that won’t take test results from anyone but their (very expensive) lab. I refuse to use any of their labs or testing facilities. They charge $700 for a Vitamin D test which they send down the hill to the lab they’ve built their cyber wall against. That lab charges my insurance about $300. I could have it done in another licensed lab 30 minutes from my home for $94 by having one of their online docs prescribe it. I feel badly enough having my insurance pay the $300, but I refuse to participant in the scam of a $700+ test being done by someone else and marked up.

    This hospital is now whining because they were shut out of our state’s “narrow network.” The insurance company says it’s too expensive–and it is. The hospital takes no responsibility for its fraudulent costs, nope it’s all the insurance company’s fault. I never thought I’d see the day my sympathies would be with a large insurance company but the day is here.

  • SarahJ89

    I’ve had my salary (along with everyone else in my agency) published on the front page of our state’s largest newspaper. It’s public information, as is the Medicare payments. And it should be. But yes, it was pretty humiliating and done to score political points.

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