Healthcare Companies’ Profits Should Be Subject to Upper Limits
The different perceptions of the reality of a hospital—from the perspective of chief executive officers/managing directors and medical directors, respectively—would be worth an epistemological digression, if it weren’t for the fact that the following real conditions make for indisputable facts: the chief executive officer/managing director is the medical director’s superior, and according to the well-known principle that higher beats lower, their view of affairs imposes obligations on the medical director.
And the perspective of the CEO is forged unequivocally by the criterion of profit and profit maximization, with medical ethics—which deals with the quality of the medical services rendered and the patient’s wellbeing—clearly taking second place.
If, for example, a CEO reduces intensive care facilities against the urgent advice of all his/her medical directors, in order to cut costs, s/he puts patients at risk. If s/he reduces staff numbers in the nursing and medical areas, s/he puts patients at risk. If, however, a treatment error that has been caused essentially by such decisions happens to have legal consequences, it is in current legal practice usually the medical director who is indicted—and not the CEO/managing director, and even less so the business unit manager of the healthcare company, who in turn had previously pressurized the hospital’s CEO/managing director, nor board members of a healthcare company that is listed on the stock market—when all of the latter impose and make compulsory the economic constraints within which “their” hospitals operate.
On the basis of my own experience I find the conclusions reached by Wehkamp und Naegler (1) expressed in far too restrained a manner. Doctors in senior positions need to maintain independence in their medical decisions and require far more protection in the current system—politicians should urgently react! The profits that hospital owners/organizations make from hospitals should be restricted to a certain level.
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|1.||Wehkamp KH, Naegler H: The commercialization of patient-related decision-making in hospitals—a qualitative study of the perceptions of doctors and chief executive officers. Dtsch Arztebl Int 2017; 114: 797–804 VOLLTEXT|