GUEST COMMENTARY: Providence CEO insults Alaska physicians
The Alaska State Medical Association represents over 600 physicians statewide. As physicians we are very aware of the necessity to provide quality and cost-effective medical care to our patients. Many of our physician members are outraged by the Providence Alaska Medical Center CEO Bruce Lamoureux’s Aug. 12 speech at the Anchorage Chamber of Commerce luncheon as reported in the Alaska Journal of Commerce Aug. 18 edition.
We have significant concerns about his vision of the future of healthcare. Not only are his statistics questionable, but his views are a professional and personal insult to every physician in the state. He also indirectly insulted nurse practitioners and other mid-level practitioners.
Mr. Lamoureaux’s assertion that “only 55-65 percent of the time a correct diagnosis is made” by independent physicians, is both factually inaccurate and insulting. He claims that independent physicians “might not have access to the most recent information.” Instead, “second-tier nurse practitioners” have better access to information and therefore are better able to diagnose and prescribe treatment, all at a lower cost than physicians.
How logical is it that practitioners (physicians) with approximately 10,000 more hours of education and clinical training would not have access to the same technology, and would stumble stupidly and expensively as a result?
The Alaska State Medical Association offered Mr. Lamoureux an opportunity to explain and clarify the reported remarks. He acknowledged that the quotes were accurate, but claimed that the interpretation was “in some cases misleading and distorted.” He did not, however, correct any of those with the Journal editor.
The summary of the follow-up discussion seems to reflect that the only part of the article he did not take ownership of was the statement that “the new competition will force physicians off their pedestals.” He stated that was the “one sentence in the whole article that is most distressing to me.” We certainly agree with him that it was offensive. However, the rest of the speech was no less offensive.
Mr. Lamoureux said that he took his figures of independent physician misdiagnosis from a speech given by a physician who alluded to a 2003 article from the New England Journal of Medicine. The article in question, and the specific figures Mr. Lamoureux quoted, were noted to be factually inaccurate by the editors of the publication in the very same issue it was published, and the article’s premises, methodology and conclusions were further disavowed in later peer reviews.
Mr. Lamoureux deliberately misrepresented the conclusions of a 10-year-old study, ironically to make a point about modern technology and to insult independent physicians.
Mr. Lamoureux champions transparency and pricing as an “earthshaking change in the healthcare industry.” He implied in a hypothetical example that hospital charges for radiology studies may be cheaper than independent offices. That assertion is absolutely incorrect. Actually, a recent survey showed that hospital charges for a CT scan were from approximately 2 ½ to 3 ½ times more costly.
Blue Cross did a survey of surgery centers and found that independent centers perform procedures at a cost 47 percent less than hospitals and provide equal or better care. As one physician stated, “he may want to avoid throwing stones since he lives in a very fragile glass house.”
A very pertinent review of hospital charges and lack of transparency was the Brill article recently in Time Magazine. This is an important report for anyone interested in medical care and medical costs.
The question remains, does Mr. Lamoureux truly represent the attitude of Providence Hospital? There was no real explanation or apology at the recent discussion with the Alaska State Medical Association representatives.
The talk at the Anchorage Chamber of Commerce was a disservice to the Providence facilities in a very public form. The attitudes expressed were insulting to physicians and nurse practitioners, misleading to business leaders, and alarming to patients.
Mr. Lamoureux represents the largest non-government employer in the state. Providence is an important part of our medical community. It is a quality institution because of the people who take pride in care of patients.
This is a time of great transformation in our healthcare system. Looking at an uncertain future for medicine is distressing to both practitioners and patients. We in the healthcare industry need to focus not on things that polarize us and not on self-serving posturing, but on the reason we are here: patient care. It is more important than ever for the healthcare system to work together including hospitals, all providers, and payers.
Dr. Cole is the president of the Alaska State Medical Association.