A health care legislative assistant that had looked at our online pricing told me that our listed prices were lower than what Medicare pays local Oklahoma hospitals for the same surgeries.  I want to be clear.  The combined bills of the surgeon, anesthesiologist and facility at our surgery center are less than what Medicare pays a local “not show a profit” hospital for the facility, alone. 

He asked me if I would sign an agreement to perform Medicare outpatient surgeries at our facility at our website prices.  I told him “no.”  He said he suspected that answer having read some of my blogs.

Remember that the hospitals lobbied successfully to not only obtain higher Medicare reimbursement than physician-owned facilities, but they also were able to secure punitive pricing for these competing surgical facilities.  Still wondering why Medicare is going broke and why the cost of health care is so high?

A local “not show a profit” hospital administrator recently stated in an article that the reason she got in the medical business was “to serve.”  Maybe serve caviar and champagne at the board meetings.  Regular “servings” of bankruptcy ooze from hospitals like hers.  These piranhas have played the central role of bankrupting the entire health care sector and even the government.  Maybe she will sign up to “serve” at a soup kitchen to many of those she has put in the poor house. 

As a physician and a facility owner, I can’t divorce myself from the patient’s financial condition.  I can’t say to a patient, “that’s the facility’s charge and there’s nothing I can do about it, “ like this hospital administrator.  While many physicians want to divorce themselves from the “business” of medicine, I contend that this is one of the most critical roles physicians can play in the care of their patients, as no one has more cost knowledge or leverage in health care than the physicians themselves. 

Relinquishing this role may make a physician feel pure in their altruism, but the reality is that this may be one of the most vicious and costly forms of patient abandonment.   As patient advocates, all of us as physicians must do a better job identifying the true costs of care and questioning these amounts for the benefit of our patients.   Countless parasites make handsome livings because they count on us recoiling from this duty.  “I just want to take care of people and leave the money stuff to someone else.”  How many times have you heard this?  I think we can do better. 

Owning and controlling our surgery center and openly discussing prices and costs of procedures with patients have resulted in care for thousands of individuals who could otherwise never have afforded it.  This is the market at work and also the result of a large group of cost-fluent physician partners with whom I am proud to be affiliated.  Leaving the financial component to people like a “service” focused administrator is like feeding patients to the wolves.  It is a cop-out and many times results in bankruptcy or worse.

G. Keith Smith, M.D.