WASHINGTON — With hospitals buying up medical practices around the country and seeking to make the most of their investment, the American Medical Association reached out to doctors this week to remind them that patient welfare must always come first and not be overridden by the economic interests of hospitals that now employ doctors in ever-growing numbers.
“In any situation where the economic or other interests of the employer are in conflict with patient welfare, patient welfare must take priority,” says a policy statement adopted by the association.
For decades, doctors in picturesque Boise, Idaho, were part of a tight-knit community, freely referring patients to the specialists or hospitals of their choice and exchanging information about the latest medical treatments.
But that began to change a few years ago, when the city’s largest hospital, St. Luke’s Health System, began rapidly buying physician practices all over town, from general practitioners to cardiologists to orthopedic surgeons.
Today, Boise is a medical battleground.
After David Hubbard underwent a routine echocardiogram at his cardiologist’s office last year, he was surprised to learn that the heart scan cost his insurer $1,605. That was more than four times the $373 it paid when the 61-year-old optometrist from Reno, Nev., had the same procedure at the same office just six months earlier.
“Nothing had changed, it was the same equipment, the same room,” said Dr. Hubbard, who has a high-deductible health plan and had to pay about $1,000 of the larger bill out of his own pocket. “I was very upset.”
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AUSTIN – Walter Simonds went to the emergency room on a Saturday night in February with a stabbing pain in his right side. After two hours at Seton Medical Center Austin, Simonds learned he had a large kidney stone.
Seton billed Simonds, a self-employed writer who is uninsured because of the high cost of individual coverage, $8,716 for the 128 minutes he said he spent mostly waiting in the ER. That works out to about $68 a minute and does not include the $887 Simonds had to pay the ER doctor or the $330 he paid a radiologist to read his $7,200 CT scan – about double the cost of a CT scan at St. David’s Medical Center, according to the charge-comparison website NewChoiceHealth.com.
In the middle of the night, Augustin Hong, a 34-year-old financial professional living in San Francisco, started to experience abdominal pain so severe it sent him to the emergency room. After some tests, doctors told him he had appendicitis and needed surgery — and that without surgery he could die.
He took his doctor’s advice without hesitation. The routine surgery to remove his inflamed appendix went off without a hitch, and doctors sent him home the day after his surgery with a small bottle of pain pills — and a medical bill of nearly $60,000.
At first, the large bill didn’t faze him.
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