Hospital Systems vs. Hospitals

My Quora Answer to:
What does no one tell you about hospitals?

That hospitals in the U.S. are now overwhelmingly run by people who have never taken care of a single patient in their lives. There are several implications and consequences to this.

Gone are the days of the friendly community hospital. They were places where people were born, treated like family when sick, and of course, died. Usually surrounded by family and friends.

Most have now been taken over by the corporations called hospital systems. Many buy out community hospitals and then either close them or turn them into clinics and ER's. Patients who are sick enough to be admitted are then sent by ambulance to their main facility, often 20–30 miles away. Which kinda spoils the “community” thing.

Physicians then become employees, serving as medical directors and committee heads, but have to follow the party line or whatever needs to be done to keep their jobs there. Your local primary care doc acts more like a traffic cop, referring patients to specialists because that's where the money is. And making money is why hospital systems exist.

While there will always be exceptions, most physicians really are in medicine because they care about people. Money is secondary. I know that comes as a surprise to most people but just ask around to see for yourself.

A hospital system's second motivation is image, and that's where the confusion with “care” comes in. Look at all the billboards that proclaim their success rates and compassionate care.

The drive to make money applies to non-profits, too. The insidious ways they exploit 501(c)3 status would make your nose hairs curl, but that's another Answer altogether.

In summary, hospitals these days are run by non-physicians who usually have a degree in Hospital Management. Like all good executives, their bottom line is money, with image close by.

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