Complications and Financial Conflict of Interest

Written by: Leah Jeunnette, Ph.D.(c)

In most fields, when providing a customer a service, if there are problems or complications that are directly caused by the provider, making the customer pay additional fees to correct the problems or complications is unheard of.  However, in medicine this is not always the case.

In a new article published by JAMA, the authors consider the discrepancy between surgical complications (as a result of the healthcare professional) and charging the patient, thus making the hospital more money.

This is a definite financial conflict of interest.  If a healthcare professional makes a mistake, then why is a patient paying for the resulting costs?  In 1999, The Institute of Medicine published their findings regarding the rate of errors and the discussion has been in play ever since.  According to the article, Relationship Between Occurrence of Surgical Complications and Hospital Finances, major complications contribute to an extra $11,500 per patient.  The hospital should not be benefiting from the complications.  While not explicitly stated, one should wonder, what is the incentive to prevent surgical complications if the hospital is profiting from them?  This is not to say that surgeons would intentionally harm patients to increase hospital costs, but rather why would the hospital spend additional money to investigate and set up better methods to prevent surgical complications.

Why would a hospital want to make changes that would create a financial loss?  One might argue that the hospital would never take advantage of individuals, or that a hospital would prioritize finances over patient safety and care.  However, history has proven over and over that patients are not always the priority.  Finances play a huge role in decisions that healthcare facilities make.

So what should be done then?  Should the current model of pay for services be abandoned?  Should there be a law passed that prevents hospitals from charging patients for surgical complications?  Who should pay for the complications? Should the hospital absorb the cost or should it come out of malpractice insurance?  I am not sure that there is a clear answer or solution to this problem.  However, that does not mean the discussion should be left.  Those in healthcare should consider these questions and look at possible solutions to this financial conflict of interest.