With hospitals buying up medical practices around the country and seeking to make the most of their investment, the American Medical Association reached out to doctors this week to remind them that patient welfare must always come first and not be overridden by the economic interests of hospitals that now employ doctors in ever-growing numbers. "In any situation where the economic or other interests of the employer are in conflict with patient welfare, patient welfare must take priority," says a policy statement adopted by the association. "A physician's paramount responsibility is to his or her patients," the association said. At the same time, it added, a doctor ?owes a duty of loyalty to his or her employer," and "this divided loyalty can create conflicts of interest, such as financial incentives to over—or under—treat patients."
After billing Medicare for treating more than 1,100 cases of a rare affliction, a Prime Healthcare Services hospital in Redding abruptly stopped last year, state health records show. The change occurred soon after California Watch published a story about aggressive billing practices at the hospital. About six months after it took control of the Shasta Regional Medical Center in Redding in late 2008, Prime began billing Medicare for treating senior citizens it diagnosed with kwashiorkor, a dangerous nutritional disorder usually seen among children during famines in developing countries. At its height, the hospital's billing for the malady surged to nearly 70 times the state average. Prime said in a statement that its Medicare billings are legal and accurate. It declined to respond to follow-up questions.
Records of several surgeries performed three years ago at the University of Toledo Medical Center will show those operations were completed without problems, but identifying the doctor who performed the operations could be more difficult. A nonprofit firm that conducts medical billing for UTMC doctors also investigates mistakes among the 100,000 or so bills sent annually to government and private insurance companies. In 2009, the University of Toledo Physicians Clinical Faculty Inc. investigated the billing of surgeries for at least two doctors and ultimately issued some refunds, according to a confidential document obtained by The Blade.
Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the profession. But now one of the nation?s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four. Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.
For the first time, cash salaries paid to Dayton-area nonprofit hospital executives have topped $1 million. Fred Manchur was promoted to chief executive officer of Kettering Health Network in late 2010. He received a 43 percent salary raise in 2011 that brought his base pay that year to $1.1 million, according to tax forms filed in November. Manchur also received a $268,335 bonus last year. Altogether, his salary, bonus and benefits totaled nearly $1.9 million.
They were reluctant litigants—women who spent decades building esteemed careers and conducting groundbreaking research, while raising children. They came from the country's best colleges and doctoral programs to teach at a medical school in the heart of Newark. They brought in, on average, more research dollars than male colleagues. And, according to a 5-year-old suit that was settled this month, they were systematically underpaid as male colleagues outpaced them in salary and promotions—year after year.