The Golden Seal Scam
This is where the free market has work to do:
California is the only state with more than 1,000 surgery centers that has given private accreditors a lead role in oversight. Those accreditors are typically paid by the same centers they evaluate.
That approach to oversight has created a troubling legacy of laxity, an investigation by Kaiser Health News shows. In case after case, as federal or state authorities waved red flags, state-approved accreditation agencies affixed gold seals of approval, according to a KHN review of hundreds of pages of doctors’ disciplinary records, court files and accreditor reports — which are public only for California surgery centers.
Listen, we need to do better. We can’t let bogus 3rd parties, who are paid off by the people they work for, be in charge of giving out these golden seals of approval.
How do we fix this? Looking for your thoughts, Keith Smith MD.
QUIS CUSTODIET IPSOS CUSTODES …
… nothing new under the sun to see here
This problem belongs on Pete Stark’s doorstep. He set up harsh criminal laws to break up doctors’ financial involvement in hospitals, which found to be a conflict of interest. I hope he is satisfied with what he got.
What were the little private “not-for-profit” doctors’ hospitals and surgeries? They represented a doctor’s, or a few doctors’, property. In spite of our modern prejudice that quality only occurs at the muzzle of a gun, these centers lived and died by the opinion of the hospitals’ users and colleague physicians who referred patients to them for care. When medicine was a collaborative profession, a bad outcome or legitimate patient complaint was amplified through the community.
What do we have now? Giant nationwide entities own dozens or hundreds of centers that can vastly differ in quality of services. The people at the top don’t know what’s going on at the facilities, so they require metrics; and they require metric generators called quality analysts to tell them whether the facilities are performing, or underperforming.
In the community a physician might have a $1 million dollar stake in the hospital; but the farmer has a $1 million dollar stake in the farm, and either one of them could go broke if they aren’t watchful. Today, an assistant vice president has zero stake in the surgical center, but $500,000 a year income. After two or three years, all that stake is tucked away in untouchable investments, not in a fragile and vulnerable place like a hospital.
Pete Stark has left us with a merry-go-round of irresponsibility, cost shaving and worsening care. I’m sure that he had no intention of doing that, of course. But he didn’t do it on a whim; he spent years installing the cabling and plumbing for the skyscraper Big Medicine, all the while claiming that little medicine needed someone to watch over it. Guess what, Pete? Now it does.
” he spent years installing the cabling and plumbing for the skyscraper Big Medicine, all the while claiming that little medicine needed someone to watch over it. Guess what, Pete? Now it does.”
The road to hell…..
BTW, just found this in my e-mail:
https://www.complianceiq.com/trainings/LiveWebinar/1955/the-disruptive-practitioner-a-danger-to-the-hospital-s-operation?remindme=true
Your post should generate a lot of discussion. First. Kaiser Health News. Their pro-hospital bias and anti physician owned facility bias is completely off the charts. One recent hit piece by them against physician owned facilities can only be described as a swing and a miss, the bias was so gross. Second. The absence of market forces in the industry is what allows waiting rooms to be full at facilities that are “in network,” whether they are any good or not. Restaurants go out of business when they are awful. Hospitals and other facilities can continue to thrive, as patients continue to patronize facilities recommended by a larger number of hospital employed primary care docs, under the gun to make these referrals, as you know. Government, having assumed the primary “inspection” role of facilities, crowded out the market’s chance to do so effectively. This is like saying the free market has a lot of work to do delivering first class mail. The real purpose of this article might be to deflect attention away from sporadic and shoddy quality in the inpatient space. I believe an Underwriters Laboratory type of approval stamp is in our future for the medical industry, but the government must get out of the way, first. Many of the boxes that are checked during inspections are driven by approval required by Uncle Sam to take his loot. Just my initial thoughts. Thanks for all that you do.
You mean like JACHO?