Proponent testimony by

David Yashon, M.D., F.A.C.S., F.R.C.S.(C.)

Central Ohio Neurological Surgeons

House Bill 71

Physician Self-Referral

House Health and Family Services Committee

Wednesday, April 30, 2003

 

 

Chairman Jolivette, members of the House Health and Family Services Committee, thank you for the opportunity to speak in support of House Bill 71, the measure being considered to  extend state law on physician conflict of interest to inpatient hospitals.

 

My name is Dr. David Yashon and I am a currently neurosurgeon in private practice at the Central Ohio Neurological Surgeons here in Columbus. I appear before you today to make sure you know that there are doctors who support this legislation and who urge its passing, sooner rather than later.

 

What is good for the patient should always be paramount. Nothing else can or should compete with it. It is at the very least, naïve to think that if a profit motive is involved it has no influence on patient care. It does. Studies have shown that utilization goes up and unnecessary services are provided when physicians own the facilities to which they refer patients. This may not be a popular fact, but it is fact, nonetheless.

 

No matter how much you hear about increasing consumerism in the health care marketplace, most patients rely absolutely on their physician’s recommendation of treatment facilities. Simply, they go where the doctors tell them to.

 

 It’s understandable, given the deregulation of the hospital industry that some doctors would try to take advantage of the opportunity to earn more in a for-profit health facility in which they are investors. It doesn’t make it the right thing to do, however, for patients. Our knowledge of human nature and good common sense tell us that, if a conflict exists between making a profit and delivering health care, patients may suffer. We should not risk this.

 

If all physicians’ motives were truly altruistic – delivering the best patient care in the best possible environment – why are boutique hospitals only developing in the most lucrative specialty areas? And why is physician ownership required? It’s about money, plain and simple. Personally, I am appalled by the greed I see in medicine today. Appropriate treatment should always be about what’s best for the patient, not what fattens the doctor’s wallet.

 

Passage of House Bill 71 would eliminate this referral conflict in inpatient facilities. The majority of healthcare dollars are spent on inpatient services. It’s not going to get any less costly if we duplicate existing services, further fragment the system and jeopardize the continuity of care with “focused factories” that skim only the most well-reimbursed services provided to the best-paying patients in order to increase the income of those doctors that involve themselves in these ventures.

 

The bill that you are now considering merely extends the intent of the law now in place to remove certain self-referral conflicts of interest from consideration. When passed, it will make my job and that of other physicians easier as well. It’s a narrow way to proactively address a situation that has the potential to cause great harm.

 

With the profit motive removed from specialty hospitals, we can be assured that patient care will continue to come first. The peace of mind that will bring to me, other like-minded physicians, and to my patients, is welcome.

 

Mr. Chairman, members of the Committee, thank you again for the opportunity to speak in support of House Bill 71. I would be happy to answer any questions you may have.