Innovations will never come from insurance companies

by admin on 10/10/2018 1:26 PM

Innovations in the American Health Care Network will not and cannot come from insurance companies. They are in the business of making a profit as all good corporations seek to do. They have to remain profitable to be able to sell shares and grow. The corporate practice of medicine was outlawed in most states. They have bypassed this issue by practicing as a foundation. This was initially started by the large clinics like Mayo.

Can a nonmedical person own a medical practice? 

Answer: A nonphysician cannot employ a physician OR own a medical practice that employs a physician OR partner in a medical practice with a physician. Only physicians can employ or partner directly with other physicians. … Sure, hospitals and HMO’s employ physicians but they have lobbyists in Washington. Eliminating the corporate practice of medicine doctrine entirely, is something that Georgia, Hawaii, Nebraska and Missouri have already done. But is this good for patient care?

During the past several decades as Insurance companies have designed HMOs with contracts with physician groups the adverse effects of these arrangements have become evident. They indirectly control the physician’s judgement in the clinical decision make process. They have established reviewers in essentially every ward of most hospitals. These reviewers are primarily Registered Nurses. They alert the hospital administration or the insurance carrier concerning patient care. They will alert their superiors concerning Length of Stay (LOS) and the physician about terminating care after so many days. They will alert their superiors concerning the care if they think best practices have not been used.

When doctors have several reports of inappropriate care, they are further reviewed in the Medicine Committee which reports to the Medical Executive Committee. They can then restrict the physician’s privileges or even or suspend his medical staff privileges. It the hospital practice is his major source of income, he will lose that source immediately. The review process of a medical hearing may take a month or more. His loss of income continues as long as he’s suspended. If he’s not reinstated, it will then be reported to the State Medical Board. He will then face the board for an interview and further action. The Medical Board can suspend his license and he will be reported to the Physician’s Data Bank, which is the permanent Tomb for Physicians. It is unknown if any physician survived this to return to practice. For all practical purposes the physician has lost his license which cost him around one half million dollars in investment by his family or himself.

This is a very ignoble end for a person in the Noble Profession of Healing and Health Care. There are a number of very hostile and adversarial groups for physicians. One government program has admitted that they are targeting physicians like the Taliban. Many physicians are leaving practice before they had plan so they would not be targeted.

So the bottom line is that physicians are at risk of profession homicide when they become employees and do not make decisions in the best interest of their employer.

We will explore this further in this HPUSA Journal. Stay in tune.

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