1. Heaviest growth correlating directly to states without state regulations requiring growth based upon proven community need. Texas had largest growth with most of the doctor- owned hospitals in North Texas, many in the Dallas Ft.Worth metroplex .There is a map of Dallas area doctor-owned hospitals. [PDF] Trend WaTch (Free subscription to view).
2. A financial stake in health care facilities creates potential for conflicts of interest between patients and financial needs of doctor.
3. Doctor-referrals benefit doctors by increasing value of investment, adding personal share of facility profits in addition to normal professional fees.
4. Doctor ownership influenced where doctors directed patients for services - driving up referrals for services. Doctors tend to increase number of patient referrals to specialty hospitals if they own it.
5. Volume and spending increased as doctor-owned specialty hospitals opened. 121% increase in complex spinal fusion services with 91% performed in doctor-owned hospitals vs full-service hospitals.
6. 11% higher growth in procedures per Medicare beneficiary of artery bypass grafts performed on Medicare beneficiaries at doctor-owned facilities than by surgeons using community hospitals
7. Profit margins higher for doctor-owned facilities vs acute care hospitals; suggesting increased profits drove up the cost of health care.
8. Although laws prohibited "kickbacks" and inappropriate doctor referrals, loop holes made it easy to skirt the laws.
9. Doctor-owned, limited-service hospitals have higher than average costs - consistent with low occupancy/volume; offer no emergency services - greater control of the nonpaying patients.
10. Patient benefits include gourmet meals, private rooms, family accommodations. Doctors "cherry pick" patients - reject low income patients.
11. Doctor benefits include ability to perform more procedures in less time; no emergency on call responsibilities; predictable work hours; sharing in facility hospital profits.
12. No increased quality of care. Doctor owned hospitals get larger share of highdollar patients, leaving full hospitals with lower income patients and having to cut services because of the loss of higher paying patients.