The recent 60 Minutes segment alleging that Emergency Room physicians are asked, even pressured, into admitting Medicare patients by Health Management Associates was completely off mark and, while I would normally simply ignore such a biased story, I feel compelled to defend my profession! What I find most offensive is the implication that my integrity and my commitment to providing the best possible medical care to my patients is somehow malleable. The thousands of nurses, doctors and mid-level providers who work in hospitals across the nation, providing vital services for their communities, should likewise be offended. CBS should be ashamed of this one-sided storyline thrown together and only offering statements made by a group of disgruntled terminated employees without any input from those of us in the trenches at HMA facilities.
As an Emergency Room Medical Director who has worked at the same HMA hospital for 25 years I can say, unequivocally, that I have never been asked to admit any patient to my hospital in order to meet any established goals or quotas. I am not, nor have I ever been, employed by HMA. As Medical Director I understand that evaluating performance (as with most professions) is a valuable tool. We use a number of metrics for this evaluation; including length of stay, time to exam, patients who leave without treatment and patients leaving against medical advice, to evaluate the performance of all physicians. All are valid criteria in the evaluation of a physician’s performance.
However, admissions are not used as criteria to evaluate the performance of any physician nor have admissions ever been a part of that criteria. An additional important point that 60 Minutes failed to make is that Emergency Room Physicians actually do not admit any patients to the hospital. The decision to admit or discharge a patient is made by the patient’s attending physician after consultation with the ER physician. That decision rests solely with the attending physician. I am proud to say, that in these past 25 years of my practice, HMA truly has been a partner in our community, providing our physicians with the necessary tools to deliver top notch quality care to the patients we treat.
James D. Ford,
DO Medical Director Emergency Department Medical Center of Southeastern Oklahoma Durant