Hospitals Losing Money

More than one-third of Massachusetts hospitals in fiscal year 2011 lost money.  Ouch.  Boston Medical Center reported the largest loss, at $25.1 million.  Granted, many of them are chock full of administrators (remember that there is a ratio of 5 admins to one doctor in this country) so I am very sure they are top heavy.   Oh, and they will probably fix this by cutting services, overburdening the poor nurses, and replacing as many healthcare givers with LELTs when they can. That being said, Massachusetts is a microcosm of what is to come for our healthcare system with the ACA.   We already know that we are short on primary care docs and that trend is amplified in Massachusetts.   Now we will be short on hospitals too.  And 1/3 sounds about right.  This is very scary.

  7 comments for “Hospitals Losing Money

  1. Kurt
    September 19, 2012 at 3:30 pm

    I have that diagram printed off in color to keep around to show to people. As I’ve said before, primary care is going in the crapper unless financial incentives are made on the general population to change their poor habits. People then will hang on our every word if they know their premiums will drop if they meet some modest parameters. The carrot and stick approach could be applied to public aid too. It would be more rewarding to be a primary care
    practitioner if people changed their ways and listened to us.
    As it stands, nothing in this country is going to change. Students are staying away from FP and I don’t blame them. NP’s are going to step in and take over. That is not going to be a total answer either.
    I’ve seen them refer to nephrology for “microalbuminuria” with NO other findings. FP hospital practice is going the way of Ob and if one is just doing office work, they’re essentially doing NP/PA work in the eyes of the payors and not worth paying at a higher rate.
    If this continues, the AAFP will not be a viable entity in 10 to 15 years. It’s ashame too.

    • September 19, 2012 at 10:38 pm

      Actually, the fizzle and disintegration of the AAFP would be great. For the years they kowtowed to every external pressure, harming their own membership from P4P to linking payment to “medical home” malarkey, to supporting Maintenance of Cert’s, etc, etc, they have courted and constructed their own irrelevancy.

      • Kurt Savegnago
        September 20, 2012 at 6:36 am

        Amen to that Pat. Should just be CME and a competency test. My records are dictated and reviewed by outside people for completeness.
        I’m told I’m doing excellent. I also know of all the uncompensatable work I am doing to maintain that, results in less patients being seen and a significant drop in income. Why the hell does the AAFP want to waste their members time with this record survey B.S. for this MOC sh-t? It was a waste of time when we had to “send” anonymous chart records for some ivory tower bastard to review some years ago. There was a short period of time when the AAFP was going on just CME and testing. Should have continued the K.I.S.S. principle.
        As I said, I no longer recommend this specialty to students. Best to go internal med and shoot for a fellowship if one is not interested in Ob or surgical specialties. The ACP is only just starting up computer stuff slowly and their testing was every 10 years long before the AAFP considered it.
        I just received an email blurb from the AAFP that free standing NP practices are on the horizon. I know how good they are for office work as I supervise one. Our group practice receives better compensation for everyone by using “physician extenders”. They’re supposed to see straight forward cases but patients can be vehemently loyal to them. In my state they can’t prescribe narcs or stimulants so a doc is needed for that. All’s that would take to remedy is a legislator’s pen. I deal with their patients cold if they are admitted to the hospital but hey, that’s what’s going to happen when the hospitalists take over. They like to kick people out early ’cause they don’t give a hoot. The patients don’t end up on their doorstep sicker than snot.

  2. September 19, 2012 at 11:46 am

    The first item states that hospital administrations “will probably fix this by cutting services, overburdening the poor nurses, and replacing as many healthcare givers with LELTs when they can.” Sorry, “LELTs” is one acronym I have not yet seen. I checked online, and Google led me to, where I learned that LELT can refer to: 1) Loon Echo Land Trust (Bridgton, ME); 2) Leading Engineering Laboratory Technician; and 3) Law Enforcement Language Training (est. 1990; California). Next, I looked in MedlinePlus, only to be asked: “Did you mean felt?” OK, exactly WHO are these LELTs who will be replacing healthcare providers at the behest of penny-pinching hospital administrators??

    • Doug Farrago
      September 19, 2012 at 12:24 pm

      LELT = Less Educated, Less Trained

      I made it up. Like CNAs taking over for RNs, or NPs/PAs taking over for doctors.

  3. September 19, 2012 at 10:52 am

    Could you define “administrators”? Somehow I don’t believe that there are 5 of them per doc in MA hospitals. Are you including clerical staff in general, or insurance people?

Comments are closed.