Hospitals Steering Patients to the ER? You’re Kidding, Right?

Among health care finance professionals, it is well known that a small (but usually very vocal) minority of physicians hold extraordinarily childlike views on health care economics. Dr. Terry Bennett is a case in point. Via Kevin, MD, the good doctor makes one of the most naïve assertions I have encountered in more than twenty years in the health care industry.

Once hospitals came to own all or most of the practitioners in their area, they controlled how, when and where patients are seen, and, most importantly, how much it costs,” he said. “By simply diverting patients from outpatient care to the emergency room, a fee differential of $75 to about $1,000 occurs.

This is precisely the reverse of the truth. In reality, one of the main reasons hospitals employ local practitioners is to take the pressure OFF of their ERs. The idea is to provide a community with enough primary care access so that patients will not appear in the ER with minor ailments that are not emergencies. Why? Because reimbursement for non-emergent ER visits doesn’t come close to covering costs.

Moreover, Dr. Bennett’s depiction of employed physicians as mindless myrmidons willing to do the nefarious bidding of their masters in the hospital executive suite is ridiculous. Even if hospital administrators were dumb enough to tell our employed physicians to steer patients to the ER, the docs would tell us to go to Hell. It’s difficult enough to get them to do things that make sense.

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