Corporate Corruption of Medicine

Make hay while the sun shines.

English proverb

There’s a disturbing trend out there.

It goes by different names – one-size-fits-all, population health, and corporate care.

It shares the notion that large corporate entities can force doctors to act in the financial interests of the corporate organization.

In a New York Times opinion piece (”How Medicine Is Being Corrupted”, November 18, 2014), Pamela Hartzband. M.D. and Jerome Groopman, M.D., husband and wife and professors at Harvard Business School, nail the problem.

“Financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients. Insurers, hospital networks, and regulatory groups have put in place rewards and punishments that can powerfully influence your doctor’s decisions.”

Among these are:

• Contracts that “pay for performance.” If doctors meet certain metric targets, e.g., lowering blood pressure or cholesterol, they are rewarded with bonuses or high placements on insurer website. If they fail to meet these targets, payments are reduced or they are given low website ratings.

• Insurers reward or punish patients by giving higher or lower co-payments doctors for using specific drugs or doctors or doctors for following certain pathways for treating patients.

Insurers, and government officials, contained that “it is obsolete for the doctor to approach each patient as an individual, Medical decisions should be made on the basis of what is best for the population as a whole.”

This, argue Hartzband and Grooper, is not only wrong but immoral. It ignores clinical judgment and patient preference, and it may harm the patient.

Power, say the two authors, now rests in the hands of insurers and regulators, and in the minds of patients , in part because they rely on information provided on corporate websites.

Hartzband and Grooper propose as a solution a new public website, similar to the one provided for Physician Sunshine Act, which exposes financial ties between pharmaceutical companies and doctors. The new website would reveal the hidden coercive forces that specify treatment and limit choices for doctors and patients.

Perhaps it is time for a little sunshine on corporate interests as they make hay at the cost of patient and doctor choice. by forcing doctors and patients to follow corporate dictates on treatment.