A recent article on the website Medpage Today highlights the tragedies that can result when profit motives and medical care converge.

The article was about a three-year old girl who was born with hydrocephalus, an abnormal buildup of fluid in the brain. Despite this condition, which required a shunt to drain the fluid, the child was able to walk and dance, and she was even bilingual. The tragedy is that she died days after being admitted to their city’s children’s hospital.

A lawsuit was filed, in which the parents contend that the death resulted from negligent care by the hospital, its staff, and by a well-known physician who had been recruited by the hospital to boost revenues after years of hospital financial problems, including bankruptcy. 

When the child began throwing up, a problem that can occur with a blocked or non-functioning drain, the parents took her to a well-known physician, at his local clinic. We will call him “Dr. Jones.” When Dr. Jones moved to the city, his reputation and qualifications had been highlighted in hospital press releases. 

The lawsuit alleges that, to induce Dr. Jones to move to their city and admit patients only to their hospital, the hospital made certain concessions. For example, he was exempted from peer reviews by established pediatricians at the hospital, and complaining physicians were told they were not allowed to treat Dr. Jones’ patients. “The latter practice resulted in physicians, at times, being forced to respond to staff calls for assistance by saying ‘this is not our patient” and “we can’t help them.” 

Why did this contribute in the death of the little girl? The complaint alleges that when they took her to Dr. Jones’ clinic, he told them to go to the ER at the Children’s Hospital and that he would follow them there and treat her personally. 

However, when they arrived at the hospital, the girl was transferred to a regular pediatric floor and, despite the parents’ pleas that they treat her as she deteriorated, they were told this was Dr. Jones’ patient and he would be there soon.

Twelve hours later – with Dr. Jones still not there — she went limp and turned blue, and hospital doctors transferred her to the ICU and began treatment. She never woke up and was declared brain dead. The parents claim that the blocked drain could have easily been treated by the hospital’s physicians. 

Where does the profit motive come in? The parents contend that Dr. Jones is a qualified general pediatrician, but is unqualified and untrained in pediatric intensive care medicine. They point out that Dr. Jones made promises to the hospital that would results in massive amounts of new patients and millions of dollars in revenue each year. In exchange for these promises, the hospital allowed him to practice in specialized areas of pediatric medicine for which he was not qualified. 

It is not uncommon for hospitals in less-populated areas to recruit specialty physicians, such as in neurosurgery or critical care medicine, so those patients can be treated at the local hospital rather than being sent to a larger city. To survive financially, hospitals need patients, and it is doctors who admit patients to the hospital. To induce the specialist to come to their city and admit patients to their hospital, various agreements and commitments may be made. In the story set out in this blog post, the parents of the child contend that  this was a contributing factor in her death.