Readers react: Physician-owned facilities

As readers of FierceHealthcare know, physician-owned facilities are a hot topic, one that tends to provoke steam coming out of the ears of hospital administrators. Recently, I wrote an editorial suggesting that such facilities may be on the wane, with physicians turning to employment with health systems for refuge. I argued that while, say, owning your own ambulatory surgical center may be a sweet gig for now, in tough economic times even profitable facilities may be under strain.

Readers had a range of responses to this viewpoint, but most pointed out that physician ownership of facilities waxes and wanes over time whether there's a recession underway or not. Here's what one skeptical nurse had to say:

"The physicians will stay in the business as long as they are making money. When they can no longer cherry-pick the great paying patients and turn away the less paying patients, they will ask the hospitals to take over the overhead and continue to pay them a great salary. CMS will look to see who is making money and bind down the program with so many rules that the business can no longer work at a profit. I have been in health care for 41 years and I have seen this situation occur over and over."

That said, in the future physicians may have less opportunity to move in and out of ownership vehicles. For one thing, as an item in today's Wall Street Journal Health Blog notes, Rep. Pete Stark is mounting a fight to restrict physician-owned hospitals. In places like New Jersey and Massachusetts, ambulatory surgical centers have faced regulatory challenges. And there's been ongoing pressure on (often physician-owned) single-specialty hospitals, some of which face demands to open costly 24-hour emergency departments.

Throw in the uncertainties that go with a new presidential administration, and you might just see new dynamics emerge between doctor-entrepreneurs and hospitals. And why not--heaven knows the same old push-and-pull isn't making anybody happy. Let's hope something better comes out of all this change. - Anne