Opting out of corporate medicine

A recent edition of the New England Journal of Medicine strongly criticizes the corporatization of medicine. Corporations, they say, operate according to the logic of business, “emphasizing efficiency and financial returns, whereas medical institutions have traditionally operated as professional or charitable enterprises.” Now, medicine is market-driven and relies on private businesses to “fulfill a fundamental human need,” akin to the privatization of fire and police departments.

Because investors now supply the capital needed to support new technologies, upgraded facilities, research and development, and competitive salaries, medical organizations must make a profit. Unlike other U.S. profit-making enterprises, profits and value “often don’t align.” For example, medical firms can make money by cutting corners with “little fear of affecting demand.”

Small physician practices need money to provide high quality care. For example, they may need to purchase an expensive electronic medical records system. Or they may be unable to coordinate care effectively without becoming part of a larger provider network. For that reason, they often become incorporated into one of the large enterprises.

Not long ago, I found a physician who seemed to have opted out of corporate medicine. I needed carpal tunnel surgery on both hands and found him using a Google search. It was an interesting experience and one that I liked. His office is half of a small duplex located near a cemetery. Entering the office, you’re greeted by Kimberly, his office manager. When it’s your turn to be seen, the doctor comes into the waiting room to welcome you into his office. It’s just the two of them. I especially love the fact that, when calling the office, Kimberly answers the phone instead of a robot. 

Because the major hospital in our area is part of the Dignity corporate enterprise, this hand doctor performs his surgery at a community hospital that’s about an hour’s drive from our home—the only downside to using his services. He did a good job and I’m pleased with the outcome.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.