Do you remember when patients came first? This picture was taken in New Orleans at Marine Hospital in 1942. Back then a hospital administrator looking at this picture would have seen a patient, a doctor, and a nurse. The administrator would have acknowledged the importance of each person, but he or she would have viewed the patient as the most important person in the room. This picture depicts teamwork and patient centered care at its best.
Fast forward to 2012, the year of hospital budget cuts and the bottom line. Today, a hospital administrator looking at this picture would see a revenue earner, a cost, and a RGU. That stands for revenue generating unit. The doctor is the revenue earner. He performs procedures and brings in money for the hospital. The nurse is the cost. The hospital has to pay her even though she can’t bring in money like a doctor can, therefore she is viewed as a liability to the hospital. Then there is the RGU. Sadly, that’s the patient. Hospitals love patients with superior healthcare coverage. Unscrupulous doctors and hospitals will perform expensive procedures on lucrative RGUs, and keep them in the hospital as long as possible for the sake of the institution’s bottom line.
I wrote about how the Amanda Trujillo situation impacts nurses in my last post. Now I want to focus on how it affects patients. We are all patients. All patients are human beings who deserve to be treated with respect and dignity. Banner Health lost a huge revenue stream when Amanda saw a knowledge deficit and educated her patient about other treatment options. Banner Health’s administrator looked at the picture and saw a tyrannical money making doctor screaming for Amanda’s job and license, a nurse, or should I say a liability that upset the financial apple cart, and the patient who was now a less valuable RGU. The picture was clear. Banner Health opted to eliminate the liability to pacify their revenue-making physician, and attempted to make the RGU more valuable by refusing the patient access to hospice. Banner Health’s behavior toward the patient is unconscionable. As a patient, I want hospitals to provide care that is in my best interest, not motivated by financial gain.
I’m afraid that what happened at Banner Health is just the beginning of a frightening trend. Patient care is going to become more profit driven as more people become uninsured and as states slash Medicaid reimbursement. No patient should be ushered into the most expensive treatment option for the sake of the all mighty dollar. And no nurse should be fired for protecting his or her patient from unethical practices. The Amanda Trujillo case is about all of us. Patients are not RGUs. It’s time to put hospitals like Banner Health in check.