Administrators of hospitals, clinics and medical groups know there is competitiveness in their ranks just as there is in the rest of the business world. However, some actions to protect business interests may interfere with the quality and safety of patient care.
These administrators often promote the idea of consumers building a long-term relationship with their care providers…someone who understands the uniqueness of their health and has a more longitudinal view of their history.
Just look at the organization’s mission statement or marketing materials. They may also be concerned about handoffs in care processes to ensure patient safety. But, some of these same administrators will use restrictive covenants in their contracts with physicians and other providers.
The risks and challenges associated with failed handoffs and disruption of the physician-patient relationship were demonstrated after the mass migration that occurred after Hurricane Katrina. Large hospitals with patients receiving intensive care were evacuated and there was an exodus of the general population, including those with chronic and complex conditions.
In most cases, access to health records was no longer possible or there was an extended delay. And patients, or their family caregivers, didn’t always know what medication a patient was taking.
This brings us back to "ghosting," when a physician disappears…or is evacuated away from their patients as a result of the breakdown in a professional relationship.
A recent Kaiser Health News article shines a bright light on the potential risk to patient health and the unintended consequences caused by these business decisions. More specifically, these include noncompete clauses in employment and other provider contracts.
While the clauses might make business sense, they disrupt the therapeutic relationship and can cause inconvenience and risks to patients. In addition, consider patient satisfaction and the experience of feeling forced to continue care with an organization and new provider…or the ethical questions that arise. Some of the restrictions and potential impacts involve:
- Prohibiting the physician from communicating with patients and not providing the information patients need to make their own choice of where to obtain care. This can anger the most fearful patients and those at greatest risk.
- Distance restrictions mean patients who want to follow their provider will need to drive (or find transportation) significantly longer distances at additional costs.
- Clauses preventing providers from treating former patients — even when the patients go searching and find them. Really?
Courts are getting involved in cases involving the enforceability of some noncompete clauses, and it seems they don’t like denying patients their choice. Even the Trump administration, to balance patient choice with competition in healthcare, has recommended that states examine their noncompete clauses for their effect on patient access to care and the supply of providers within communities.
Effective healthcare leaders will find the balance between business and healthcare and ensure that the transfer of care respects the patient. This presents an opportunity to build trust and a stronger relationship between the organization and their community.
These healthcare leaders will trust patients to make the right choice for their individual needs and support those making their own decision to follow a physician.
