WSJ analysis: Referrals driven by desire to keep business in hospital systems

The Wall Street Journal (12/27, A1, Mathews, Evans, Subscription Publication) reports hospitals employ a variety of strategies to encourage physicians to make referrals that keep patients within the hospital system, even when a patient may benefit from seeing a specialist outside the network. Leakage occurs when patients go to competitors for care, threatening the $1.8 million in revenue annually hospitals see from internal-medicine referrals for services like tests, according to a 2016 Merritt Hawkins survey. As hospitals acquire more physician practices, the pressure on new physicians to avoid leakage has mounted. One study found patients pay $90 more out-of-pocket for MRIs when administered in a hospital, while doctors working for the hospital system were 27 percent more likely to steer patients to the hospital for the scan.

Unfortunately, as more and more plastic surgeons are hired by hospitals, the hospital employed internists and family physicians are instructed to refer to these hospital based plastic surgeons, despite the fact that they may not have as much experience in certain cases.   It's all about the money and hospitals want to control patient flow. 

A sad state of affairs!!!  

E.B.G.