The article by Ruth SoRelle, MPH, “Employee Status Signals Increasing Corporate Dominance in EM,” was excellent. (EMN. 2020;42:1; https://bit.ly/2JupSkC.) I agree that employee status for EPs (or physicians in general) is bad for the ideal practice of medicine. In the 23 years I have been in practice, I have become disgusted with the nonphysician oversight of the practice of medicine. I feel it is well past the time that the control of medicine be placed back into the hands of physicians. I believe this will only happen with strict legislative pressure, but I have my doubts that lawmakers will ever figure that out.
Also, wow, what an incredibly well-written article by Mark Mosely, MD. (“No Metric Bonus is Worth Your Soul,” EMN. 2020;42:3; https://bit.ly/2wW9J4R.) I have seen the slow and steady drive of hospitals and insurance companies to control the practice of medicine over my career. Initially, it was a quiet and whispered suggestion. Then it became patient satisfaction scores, which were nothing more than hospitals treating the sick and injured like consumers to grab from one another. Now, these entities shamelessly talk about meeting protocols and metrics for the sake of maximizing profit! They no longer have any ethical or moral dilemma in stating what they are after—money.
It is time that this stops. Legislative measures are necessary to reward independent practices over employers. Higher insurance payments given for patients seen by doctors personally. Painful financial penalties and enforcement of the illegality of the corporate practice of medicine that is epidemically practiced in this country by insurance companies and hospital systems. Greater control and enforcement of policy by medical staffs (most of which have now become “yes people” to administrators who inflict their vision on the staff and tell them to sign on). And regulation of the ridiculous salaries awarded to administrators. The money is what has attracted this breed of greedy people, and the lack of money will repel it.
Thank you again for the article, Dr. Mosley.
Alan T. Summe, MD