I doubt there is a hospital system in the world that makes as much profit as hospitals in the USA. Most hospitals are now just part of giant profit seeking corporations, where taking care of people is seen in the same light as stamping out widgets - merely a means to the largest profit they can conceive of, at any cost, quality be damned.
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Even “not for profit” owners still focus on the bottom line and increasing revenue. I work for an academic institution, which is less profit-focused than many, but there is still the pressure to generate income. My income is >33% based on productivity, although this is after a restructure. Previously it was >70% productivity, based on $x/wRVU. Peds does pretty well in this model, mostly because we can see a lot of kids fairly quickly and still do a good job. It is killing FP, though. Older folks with more chonic problems take more time, and although you can bill higher codes for it, it is not proportional at all. My last few visits to my FP have been cursory at best. I don’t like where we are headed, nor how the new docs in training are learning their jobs. But, I’m an old fart yelling at clouds. Sigh…
Any, back on topic, as a pediatrician, i pay attention to things a bit differently than most. When our community hospiral was bought by Sentara, one of their first moves was to eliminate the peds floor, get rid of the peds nurses and turn it into med-surg with a peds flex capacity. IOW, med-surg nurses would need to double as peds nurses if a kid got admitted. Shall we guess how well this went? Why? There is no profit in inpatient peds. Maintaining the skills and equipment needed to effectively care for sick kids costs too much to turn a profit. Kids don’t get sick often enough. Pure and simplle.
PROFIT MOTIVE HAS NO PLACE IN HEALTHCARE!
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This is what I tell every relative when they have a medicine related complaint:
Profit and healthcare are incompatible. Every dollar of profit is a dollar not spent making you better.
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Sort of. Consolidation among hospital systems has done the same thing it does in other industries - make it difficult or impossible for smaller organizations to survive. So while the big corporate hospital might be thriving (that doesn’t necessarily mean that their patients or employees are), smaller community hospitals are forced to join or die. That in turn means there is less choice for patients in where they can seek care.
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The thing is, people find themselves in need of medical services for all sorts of acute or chronic reasons: pregnancy, food poisoning, traumatic amputation, tooth cavity, diabetes, pneumonia, and so on. They aren’t the slightest bit interested in cruising a market for the value for money. They just need help.
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