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Doctor Says With More Hospitals Opening, Surgery Quality Decreases

10-31-13

Health care has taken center stage with the implementation of the Affordable Care Act and hospitals have been forced to look at inefficiencies within their operations. Executive Director of the Camden Coalition of Healthcare Providers Dr. Jeffrey Brenner told NJ Today Managing Editor Mike Schneider that he thinks the more hospitals there are, the worse the surgeries and treatments become.

There are 85 million baby boomers and Brenner said if they keep receiving the same kind of medical care as they are now, the country will go under.

“We are going to have to start making really thoughtful decisions about how we deliver care to people, and I’m not talking about rationing care, I’m talking about delivering a rational system of care to patients,” said Brenner.

An example of when smarter decisions need to be made for patients that Brenner used is with arthroscopic surgery. He explained that 650,000 arthroscopies are performed every year to repair tears in the knee. When it comes to athletes with acute tears, this surgery is successful but for people in their 50s and 60s that are overweight, out of shape and have a lot of wear and tear, this surgery is ineffective, he said.

According to Brenner, the U.S. has a system of sick care, not a system of health care, where institutions profit from illness.

“Right now it is in the economic interest of the hospital to have you come back as frequently as possible,” Brenner said. He explained 25 percent of people over the age of 65 go back to the hospital within the first 30 days after their previous visit and hospitals are profiting from that.

“If you sold a product like that anywhere in America, you’d be closed down. That makes no sense,” he said.

Currently the incentives for health care institutions are to fill the beds, fill the scanners, fill the ORs, whether or not people need to be there, according to Brenner.

There is not a lot of protection in the health care system against conflicts of interest for people making recommendations and setting guidelines, Brenner said. He added that it’s not surprising when, for example, breast surgeons recommend more mammograms because they result in more surgeries.

Brenner said that health care officials need to think about how many MRI scanners, how many open heart surgery suites and how many different hospitals are really needed to perform high-end cancer surgery.

“The problem that we have created in New Jersey is that we have a highly competitive health care system where everyone wants to do everything, every hospital wants to be a level one NICU, everyone wants to do high end brain surgery, high end heart surgery and it turns out that as you divide up the market share of those procedures, each hospital ends up doing less and less and less of them and then you’re not good at it,” Brenner said.

“Did we really need Capital Health and Princeton Medical Center to build two brand new hospitals 10 miles apart? Those cranes over those hospitals are like an invisible tax on every New Jersey resident,” Brenner said.

He said he didn’t see any taxpayers vote on the building of those two hospitals but they will be paying for them for 30 years in higher copays, higher deductibles and higher employee contributions. He said people should remember that when they drive by those hospitals.


Related: Brenner Calls Health Care System Irrational