In the old days, when a medical doctor referred you to a particular specialist, it was because the doctor knew the specialist, trusted in their skills and felt this doctor could best take care of you. Evidently, politics and marketing has taken over this once sacred practice.
HEALTH CARE CONSULTANCIES- A new and growing aspect of health care is what is being called “Health Care Consultancies”. Medical specialists like cardiologists, dermatologists and other “ologists” hire these agencies at a price tag of $3,000 – $10,000 per month to “woo” general practitioners for referrals to their clinics.
These marketing specialists go to doctors offices, much like a Pharmaceutical Salesman, and basically market the doctor they represent. Detractors say that it is hard not to be swayed by these expert’s tactics – imagine convincing TV commercials, but live. Add on to that beautiful brochures and a steady stream of thank you gifts, and evidently it adds up to more and more referrals, which are based on the advertising ability of the company instead of the credentials and abilities of the doctor.
Experts are calling this new business “white coat wooing”, and say that referrals are now being made, more and more, to the best marketer instead of the best doctor for the job at hand.
WORSE- The idea of medicine becoming more about business, and less about patient outcomes, is only getting worse. Evidently, health systems and hospitals are buying up more and more medical practices. This is kind of like Wal-mart – the businesses are getting so big that the smaller independent practices have a hard time staying afloat. Especially because once these medical business are bought, they are directing all of their doctor employees to only refer within the systems they own. In addition, these Big Business Medical Centers are actually able to shut doctors outside their employment out of the hospitals altogether, allowing only their own doctors in.
If all this seems like a shock, and is new to you, it is evidently old news in the hospital business. “Whereas patients see a hospital only as a place for serious tests and procedures, administrators see a hospital also as a collection of business areas with specific revenue targets. Go into a hospital board room, and 99 percent of the time they’re talking about referrals and physician relations,” says Timothy Crowley, a former managing director at Leerink Swann, a health care investment bank.
SCARY- To put matters into even more perspective, there is one type of problem these Big Medical Companies are trying to find a way to shut down – patient homework. When referrals are going to doctors outside their medical group, it is called “referral leakage”. One of the hardest leaks to plug is evidently patients doing their own research and finding out which doctors and which procedures would be best for their own condition. Administrators evidently see this as a growing challenge that needs to be fixed.
We’ve noticed for a while, and have read in the medical literature, that more and more hospitals were not referring patients necessarily to the best doctors for the best procedures, but were instead only offering patients treatments and doctors within their business. We have several patients that have opted for a procedure and a doctor in another state that had created a new technology, and for them their outcomes were far, far better than the options they were being given. They were not even told of this new technology, because the doctor or hospital they were using did not have it available.
A couple of new websites have come out that will allow you to research your doctors and procedures: www.certificationmatters.org and www.castleconnolly.com are two. These websites verify and rate specialists. Soon there will evidently be a comprehensive physician “report card” you can research based on millions of Medicare files. These reports will offer details on each doctor’s complication rates, their patient’s readmission rates, etc.
Hope this helps,
Dr Matt and Dr Robin
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This week’s bit of Useless Information: Preparing an Egyptian mummy sometimes took up to seventy days. Dead Egyptian noblewomen were given a few days to ‘ripen’ so the embalmers wouldn’t find them too attractive.
This email is courtesy of Matthew Barnes, D.C. and Robin Barnes, D.C. Neither this nor any of our emails are intended to be medical advice and should not be taken as such. They are opinion and are for informational purposes only. None of the nutrients discussed here are meant to diagnose, treat, or cure any disease.