The practice of medicine has long been considered one of the noblest professions, with its foundation rooted in principles such as the Hippocratic Oath and a fundamental commitment to empathy and patient care. However, over the past few decades, a significant transformation has taken place in the healthcare industry, with the rise of Profit driven hospitals. These profit driven entities like corporate hospitals despite bridging the gaps in n State of art quality care are facing strong accusations of being profit-driven, often publicly traded, and can raise questions about whether the principles of the ethical and moral values traditionally associated with medicine are compromised in Profit driven hospital settings. How do patients experience and consider State of art in such types of hospitals? This piece attempts to explore the scope of Profit driven hospitals in improving healthcare accessibility for filling the gaps in healthcare services with a particular focus on the current health scenario in Low middle income territories like ours.
The Hippocratic Oath, attributed to the ancient Greek physician Hippocrates, is a foundational document in the history of medicine. It embodies a set of ethical principles and professional guidelines that have guided physicians for centuries. Some of its key tenets include: “The obligation to prioritize patient well-being above all else. The avoidance of over-treatment or unnecessary procedures. The rejection of financial gain as the primary motive for practicing medicine.” These principles have been instrumental in shaping the medical profession's identity as a noble and ethical endeavour, focused on patient care and well-being rather than profit. However, the advent of Profit driven hospitals has raised concerns about whether these principles are still upheld or undermine the ethical practice of medicine. We need to re-examine the dynamics of Profit driven healthcare and healthcare disparities, to answer the question.
Profit driven Hospitals at crossroads
Corporate hospitals often provide advanced medical facilities and services, attracting skilled healthcare professionals and patients who are looking for quality of care with latest advancements in medicine. They contribute to the community by offering specialized treatments, cutting-edge technology, and streamlined processes. This can lead to better patient outcomes and enhanced healthcare accessibility. One of the primary concerns to patients and empathetic care providers surrounding such hospitals is their profit-driven nature. Unlike traditional nonprofit or public healthcare institutions, profit driven hospitals are businesses with shareholders and profit expectations.
Pressure for profit maximization is the main concern that does not attract many empathetic doctors prioritizing financial gain over patient well-being, leading to concerns about over-treatment, unnecessary procedures, and inflated healthcare costs contradicts the Hippocratic Oath's principle of avoiding harm and prioritizing patient welfare. Physicians may feel pressured to order tests, procedures, or medications that are financially beneficial for the hospital, even when they may not be in the best interest of the patient. Profit driven hospitals may focus on profitable specialties and procedures, potentially neglecting essential but less financially attractive services. This could lead to healthcare disparities and unequal access to care, which goes against the oath's commitment to equal treatment for all. However, concerns exist regarding affordability, as Profit driven hospitals tend to be expensive, potentially limiting access for lower-income individuals. Additionally, profit motives may sometimes prioritize financial gain over community welfare while they offer top-notch medical care, they must address affordability issues and ensure a balanced focus on community health.
Impact on Patient Care
Profit driven hospitals often implement standardized protocols to maximize efficiency and profit. While standardization can improve some aspects of healthcare delivery, it may not account for the unique needs and circumstances of individual patients, potentially compromising the personalized care advocated by the Hippocratic Oath. The concept of physician autonomy is closely linked to the ability to practice medicine in a manner that aligns with ethical principles and demonstrates empathy. In the Profit driven hospital setting, physician autonomy can be constrained by various factors like strict Profit driven policies and protocols that dictate the practice of medicine hindering their ability in making clinical decisions to advocate for the best interests of their patients.
Increased administrative (marketing manager) oversight which can lead to micromanagement and interference in clinical decisions. This can be demoralizing for healthcare professionals and hinder their ability to act in the best interest of their patients./. Physicians in Profit driven hospitals may face a challenge between morality and contributing to profitable business. Some Profit driven hospital models link physician salary or contributing in business to his/her patient volume and profitability. This financial incentive can create conflicts of interest, as physicians may feel pressured to increase patient throughput or order unnecessary tests and treatments to boost their income. Empathy, a cornerstone of medical practice, may be compromised in a Profit driven hospital environment where financial concerns take precedence.
Healthcare Disparities and Access
Healthcare disparities, or differences in access to healthcare services and outcomes, are a critical concern in the healthcare industry. Unarguably, Profit driven hospitals may inadvertently contribute to healthcare disparities in several ways. Profit driven hospitals may strategically choose locations and services based on profitability, potentially leaving underserved communities without essential healthcare services. This results in geographical disparities in access to care. The profit motive in Profit driven hospitals can lead to higher healthcare costs. Patients with limited financial means may struggle to access the care they need, exacerbating socioeconomic disparities in healthcare. Profit driven hospitals often negotiate contracts with specific insurance providers or may not accept Govt Gold card insurance schemes, limiting access for patients with or without alternative insurance plans. These hospitals may prioritize profitable specialties and procedures over less financially attractive areas of medicine. This can limit access to essential services that may not be as financially lucrative.
Ethical Dilemmas and Potential Solutions
Finding a balance between profitability and ethical medical practice is a complex challenge. Profit driven hospitals can implement transparent financial practices and establish clear guidelines to prioritize patient welfare. Government regulations and oversight by designating an official regulator can help ensure that Profit driven hospitals adhere to ethical standards. Regulatory bodies can set guidelines and standards that prevent over-treatment and incentivize quality care. Healthcare professionals must be equipped with the skills to navigate Profit driven pressures while upholding the principles of the Hippocratic Oath. Encouraging physician autonomy and decision-making, a strong emphasis on ethical practice and empathy can help promote business through satisfaction on patient -centered care.
The rise of Corporate (State of Art) hospitals in the private sector has introduced a dynamic shift in the healthcare industry, in accessibility to State of art modern healthcare but at the centre are implications for the core principles of the medical profession. While profit-driven hospitals are profit-driven entities, the extent to which they defeat the Hippocratic Oath and empathy within the medical field remains a matter of debate. The profit motive can pose ethical challenges and conflicts of interest, potentially compromising patient care and physician autonomy. However, it is crucial to acknowledge that not all Profit driven hospitals are the same, and there are variations in their practices and commitment to ethical standards. Healthcare professionals working within Profit driven hospitals often strive to provide the best care possible despite the challenges they face.
To preserve the noble values of medicine, it is essential to strike a balance between profitability and ethical medical practice. Fee for service is an acceptable business model; these hospitals have to make their operations transparent so that patients and their family does not feel they have been exploited, within the acceptable terms and conditions. Transparency, regulatory oversight, ethical training, and policies that empower healthcare professionals are vital components of this balance. Moreover, addressing healthcare disparities and ensuring equal access to care for all remains a critical goal for the healthcare industry. As the healthcare landscape continues to evolve, it is essential to remain vigilant in upholding the principles of the Hippocratic Oath and the intrinsic empathy that defines the medical profession, regardless of the healthcare setting. And the critical piece is that, then, you do something about it.
(The author is Certified professional in Healthcare Quality, Clinical auditor, National and international expert on healthcare standards, policy planning and reforms can be reached at firstname.lastname@example.org)