Wednesday, September 25, 2013

This Is a Hospital, Not a Hotel

"You have to realize that this is a hospital, not a hotel," was my standard response to the "hospitality" criticisms offered by the parents of my patients (I am a retired pediatric cardiologist).

Apparently this attitude no longer applies.  In a NY Times Sunday Review article entitled "Is This a Hospital or a Hotel?" (Sep 22)  Dr. Elisabeth Rosenthal analyzes the new approach that hospitals are taking.  The chief executive of a new hospital opening next year "exulted" in saying: "You feel like you could be at the Marriott."  The hospital "business" has become extremely competitive, for better or worse, and hospitals are improving their bottom line, not by increasing quality of medical care, but by increasing the quality of "hotel" services - such as hiring "celebrity chefs" to provide special menus, including quality wines.  Major hospital systems are averaging $4.5 million annually in advertising alone! Dr. Rosenthal points out that reducing the rate of medication error is not what "sells" beds. More and more it has become amenities, amenities, and amenities.  She goes on to point out that the Henry Ford health system in Michigan recently hired a hotel executive to run its newest hospital, located in the upscale city of Bloomfield.

Believe it or not, a hospital is a business with a bottom line.  Yes, most are "non-profit," but what does that actually mean.  Nothing.  It is a complex operation that pays its executives well, with the CEO's of major hospital systems easily earning seven figure incomes, not to mention the associated perks.  Many have a horde of vice-presidents (I recently counted the number of VP's of a major New York hospital system and was quite astounded when I reached 70 and hadn't finished yet!)  Yet these hospitals are extraordinarily dependent on government subsidies and, as Dr. Rosenthal indicates, this striving for luxury may be adding to the already vast cost ($2.7 trillion) of the nation's health care.

Hospitals want (and need) patient-dollars (i.e. government or insurance dollars).  They are in competition with each other and will do what it takes to bring in patients.  Dr. Rosenthal's article concludes with her description of the VIP rooms at the hospital where she trained.  "Though the views were spectacular, the cardiac arrest team could not get there as quickly as it could to the regular wards.  We called it 'a hotel near a major teaching hospital.'"

Going into a hospital? Assess re-admission rates, infection rates, mortality and morbidity rates for various procedures.  Marketing should not be what "sells" hospitals - success of outcome is what should "sell" hospitals. "You have to realize that this is a hospital, not a hotel!"

No comments: