Surgery-owning doctors do more operations

[The Straight Story]

Surgery-owning doctors do more operations


ANN ARBOR, Mich., April 8 (UPI) -- Doctors who invest in an outpatient surgery center perform on average twice as many surgeries, U.S. researchers found.

"Our data suggest that physician behavior changes after investment in an outpatient facility. Through what some have labeled the 'triple dip,' physician owners of surgery centers not only collect a professional fee for the services provided, but also share in their facility's profits and the increased value of their investment," study author Dr. John Hollingsworth of the University of Michigan Health System said in a statement. "This creates a potential conflict of interest."

In the last 10 years, the number of U.S. outpatient surgery centers increased nearly 50 percent, largely driven by the investment of physicians, who had a stake in 83 percent of these facilities, Hollingsworth said in a statement.

The study, published in the journal Health Affairs, found outpatient surgical owners operated on an average of twice as many patients as non-owners and, while caseloads increased overall during the study period, the increases were more rapid and dramatic among the outpatient facility owners.

http://www.upi.com/Health_News/2010/04/08/Surgery-owning-doctors-do-more-operations/UPI-56981270706655/

[MannyGoldstein]

1. A Nation of Physician-Entrepreneurs

A fabulous recipe for success.

[FBaggins]

2. The author appears to confuse cause and effect.

Doctors who perform more surgeries would also be more likely to purchase their own facilities.

[sendero]

4. It is a conflict..

... of interest that no amount of pseudo scientific jargon can mask.

[FBaggins]

5. Pseudo scientific?

Farmers that own their own tractors probably grow more food. Tutors that have their own facilities tutor more students than those that don't.

[Statistical]

7. That isn't the claim of the study. n/t

[Statistical]

6. Not true.

"Our data suggest that physician behavior changes after investment in an outpatient facility."

Surgery rate INCREASES once Surgeon is a (part) owner of Surgery center.

[FBaggins]

11. There's a difference between data and what they claim it "suggests"

If you're going to go around with the name "Statistical" you should know this. :-)

The study compares those who own to those who don't. It tries to draw a conclusion about what happens when a given doctor moves from one set to the other... but they don't say that this is what they measured.

On edit - Never mind... a more comprehensive reporting of the study says that they DID compare before/after.


http://www.scienceblog.com/cms/doctors-ownership-surgery-center-operate-more-often-u-m-study-finds.html

I retract my statement and instead criticize the author of this piece who couldn't provide a clearer link but instead selected a less usefull one.

[sendero]

3. Surprise, surprise, surprise..

... and doctors who own labs order more lab tests.

Everyone knows about these abuses but nothing is done.

[Uben]

8. DUH!

In public and private hospitals, doctors share OR facilities. It is VERY COMMON to find surgeons who cannot get ample OR time, so, of course they want to invest in a facility where they can get more time. The fact that they do twice as many surgeries is not surprising, that's what the intention was!
In my small town hospital, one of the most common gripes among medical staff is lack of enough OR time. They literally have to move their practice in order to get enough OR time to sustain their businesses. To infer that doing so is somehow a bad thing is so disengenuous. On one hand, people complain that they have to wait so long to get surgery, and now on the other hand they complain doctors do twice as many surgeries at a facility they invested in so they can do just that! Get a clue!

This is not journalism. It is merely a "Fox News" type of article that takes a fact and blows it out of proportion to make a critical statement about doctors. Do doctors that invest in surgical centers do more surgeries? Yes. That was the intention!
Otherwise their practices would suffer immensely! It is just like any other business. They strive to succeed and (gulp) make more money! I would liken it to a store expanding display space to sell their products to make more money.

I'm not saying there are not some doctors out there who are not ethical, but using this fact as a somehow bad thing is not fair.


(disclaimer-I am not a doctor, nor are there any doctors in my family. My dad has served on the local hospital board for ten years, and competition for OR time has been the biggest point of contention among staff)

[eilen]

9. Isn't it better for a surgeon to have done more of the same type

surgery that one that has done less? I'd rather go to a guy that has done 100 of the surgeries than one that has done 10. People become more efficient and proficient the more experience they obtain. How is this a bad thing?

Edited to add-- I never see established surgeons overwork themselves in the OR. They do get plenty of R&R. This is not the same as say, truck drivers or airline pilots worked beyond their level of fatigue.

[supernova]

10. The report of that study lacks context

Sure, there might be a certain amount of "when you're a hammer every problem looks like a nail."

Is there no data to say how many surgeries are more than might be expected? How can you say that a certain number of patients who go to surgery centers, don't need surgery? By the time you get to a dedicated surgery site, you're pretty sure you need the procedure.

This is a couple of self selecting populations, afterall: doctors who want to do more surgeries; patients who really might need surgery.

Unless it's in the original study report, the methodology seems flawed.

[Odin2005]

12. Whouda thunk it!?!

:sarcasm:

[postulater]

13. It's not just where they do the surgery.

"A study of Medicare patients shows that costlier, more complex spinal fusion surgeries are on the rise — and sometimes done unnecessarily — for a common lower back condition caused by aging and arthritis.

What's more alarming is that the findings suggest these more challenging operations are riskier, leading to more complications and even deaths."

"Aggressive marketing of devices used in complex fusions is likely playing a role in the increase, Deyo said. The marketing includes ads in medical journals and lectures by surgeons on the payroll of device manufacturers.

Allegations of kickbacks to spine surgeons for using products and questionable financial arrangements to doctors as consultants have plagued the multibillion-dollar industry. One company, Medtronic Inc., reached a $40 million settlement with the U.S. Justice Department in a whistleblower case that included allegations the company paid doctors to use its spine surgery products. The company denied any wrongdoing."

http://www.msnbc.msn.com/id/36197896/ns/health-health_care/

[Gin]

14. what is a surgeon without surgery? it's how they make their money

owning the facility is an added bonus...if it can be stopped...it should be