Terry Lichtor, MD, PhD, a neurosurgeon and professor at Rush Medical Center in Chicago, joined Becker's to discuss the relationship between physicians and the hospitals they work for.
Editor's note: This response has been lightly edited for length and clarity. If you would like to contribute to our next question, please email Paige Haeffele at phaeffele@beckershealthcare.com.
Question: How is the physician/hospital relationship changing in your market?
Dr. Terry Lichtor: Hospitals unfortunately in my opinion have a negative impact on patient care and the physician relationship. First of all, hospitals only seem interested in making money and not what is best for patient care. I am a neurosurgeon and although I do most procedures and all emergency procedures, nobody in this field does everything. There are some procedures that I do not have a lot of experience with and think that it is in the best interests of the patient to transfer to a surgeon with more experience with that procedure, but hospitals do not like this practice. They seem only concerned about losing a patient to another facility.
I have gotten a variety of complaints over the years and the hospitals never support a physician like me.
Regarding spine procedures, there are a large number of spine products which can be used for spine surgery, although in many cases the patients really do not need such a big procedure with a lot of instrumentation, but the hospitals seem to like the use of the instrumentation since it brings in more revenue. I am fairly conservative and do not use a lot of unnecessary instrumentation, which I think hospitals do not like. The more and bigger procedures that are done bring in more income for both the hospitals and the surgeons.
In summary, I would say that hospitals really only care about their profits and not about good patient care or good relationships with the physicians. I have not noticed much change regarding that issue over many years. As you know, the healthcare business has become very competitive and several hospitals in this area have closed. This is in part because Illinois Medicaid pays very little, and Medicare does not pay much more. Healthcare in itself is expensive and in Illinois malpractice is a major issue for all providers and hospitals.