It’s time for MD due diligence!
By John Whittlesey
So, recently I’m talking to one of our best program coordinators, and we’re reviewing their facility’s clinical benchmark results for 2009. I comment that Dorsal and Lumbar Spinal Fusion is their highest excess DRG this year and has increased its excess over the previous year. We drill into the data and find that the cost per case in Surgical Services is very high and increasing – hence, the driver of the excess.
Volume has also increased over the past two years, exacerbating the problem. Then the program coordinator tells me the new neurosurgeon is the one driving the volume and cost increase. The coordinator also discovered, well after the neurosurgeon was in place, that he was a part owner of the implant vendor he was using at their facility! So I ask if they bothered to do any due diligence to check out the neurosurgeon’s practice patterns or background, and the coordinator said the facility was so happy just to get neurosurgery coverage that it didn’t bother.
Really! This happens so often when it comes to surgeons. For some reason, hospitals don’t think they can/should/have the obligation to check out anything more about a physician than if they have a license, any outstanding lawsuits, or have had any disciplinary actions taken against them. I say: “What’s wrong with adding clinical and economic credentialing to the professional credentialing?”
More, now than ever, hospitals have a fiduciary responsibility to make sure their physicians will manage clinical resources effectively and efficiently.
John Whittlesey is a principal at HMC
