Ed note: This article highlights the dangers and pitfalls of the corporate takeover of healthcare. There are perverse incentives when medical care may be compromised by preference being giving to stockholder’s interests. However, there is no perfect set of incentives. Should physicians charging fee for service be given complete control? Or should physicians, like nurses, be salaried and in a non-profit structure like Kaiser. Should a government entity run the whole thing–and put limits on expensive procedures and technology? One thing for sure, the current direction isn’t working to improve healthcare. Dr. Hartsock has a point, but the ultimate answers aren’t that clear. When I worked at Group Health, administration reported to a lay board. The agreement with the medical staff was that they would not interfere with the practice of medicine. That was not a perfect system, but it was a non-profit with built-in checks and balances.
By Jenny Hartsock Special to The Seattle Times
Healthcare in America should not be a monopoly. (It shouldn’t be a business at all, but that’s a battle for another day.) Nevertheless, regional and national corporate monopolies are taking over healthcare. This means decisions about how our hospitals operate are often not made by local clinicians, but by nonclinical administrators hundreds or even thousands of miles away.
In Eugene, Ore., a local emergency medicine group was recently fired by PeaceHealth. The administrators claimed the emergency department doctors were not qualified to do their jobs, despite having served their Lane County community well for 35 years. Leaked records show that PeaceHealth dismissed the group after doctors called out its CEO for trying to influence medical decisions made for hundreds of patients at a local hospital.
PeaceHealth then attempted to hire a national staffing company, Atlanta-based ApolloMD, to replace the local doctors. It claims to be physician-owned but is in part funded by private equity. That’s illegal in Oregon, thanks to a state law banning corporations from “exerting authority over a physician’s medical judgment and clinical practices in the state.” ApolloMD created a shell company “owned” by a physician to try and skirt the law.
This did not go well. The physicians who testified for ApolloMD when the dispute reached court were accused of misrepresenting themselves by a judge. PeaceHealth and ApolloMD came out looking terrible, and immense pressure was put on PeaceHealth by the local medical staff, the state nurses union, state legislators and the media to undo its decision … and it worked. PeaceHealth has now signed a three-year contract with Eugene Emergency Physicians.
As a physician (full disclosure: I work at a PeaceHealth-owned facility and a corporate-owned medical group in Washington, which is the only way I can practice my specialty where I live) this gives me some hope. Hope that other states, like ours, can pass similar legislation. Washington in fact had an anti-corporate medicine bill that was voted down earlier this year, Senate Bill 5387. The bill would prohibit unlicensed corporate entities from controlling or influencing clinical decisions, and require healthcare companies to be majority-owned by licensed clinicians. The bill didn’t get a vote, largely due to corporate lobbying.
I encourage everyone in Washington who wants to see medicine shift back to local, physician-led management to write your state representative. You can find your representatives at st.news/find. We need to let our representatives know that we want this bill back next session. We want corporations blocked from dictating how patients are cared for in Washington state and we want healthcare that prioritizes patients and people over profits. We shouldn’t let corporations on the other side of the country decide what is the best medical care in Washington.
Jenny Hartsock is a physician practicing hospital medicine in Bellingham.












