Tuesday, March 03, 2009

Better Care or Economic Necessity?

Now with the Dow Jones Industrial Average parked to it's lowest level since 1997, hospitals are doing the best they can for their patients (and rankings) by shortening their door-to-balloon times for heart attack patients by mandating that their cardiologists be on site in the hospital 24/7. It's such a simple thing to accomplish in the name of patient care, right?

But there's a dark side to government idealism: doctors jumping through hoops in the name of "quality" as they struggle for economic survival.

As competition between hospitals for patients continues to heat up, the press for perfect care becomes more acute lest the hospital's Medicare reimbursements fall. Teams of staff are mobilized to study the door-to-balloon time process. If hospitals find they can't shave enough seconds off the door-to-balloon time process to correct this measure, they resort to constant in-house staffing spun, of course, as "better care." The pressures on doctors to "perform," faster becomes more acute, but so does the toll on their personal lives. Unfortunately, if hospitals are not careful, they may lose doctors to their competitors because of other, non-economic, real life incentives.

Then what will become of the patient's door-to-balloon time?


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