A California doctor accuses Sutter Health of

…engaging in unlawful and unfair business practices, including wrongfully terminating and punishing doctors who disagree with, and refuse to follow, various policies and practices of the giant health care system. Those policies and practices, as detailed in the lawsuit, include reducing “Leakage” (the referral of patients outside the Sutter Health Network), pressuring physicians increase their productivity and “Through put” (seeing more patients and billing more RVUs)…

A short flurry of thinking:

When I was young I had doctors working for me. I treated them like owners who, like the rest of the employees, were asked to follow the rules and work hard. We did everything to keep our patients from going to our competition. The employees always got paid. If I didn’t work hard and control my clinic costs I (as the owner) faced my wife without a paycheck (this happened twice until I realized that health care delivery resources were not unlimited). If one of the physician employees had brought me to court it might have been the end of my practice. As more physicians become employees, fewer will ever face these realities

The story of Sutter Health got me thinking about what’s the same and what’s different. And certainly things have changed since 1994.

Opinion on this situation will vary depending on the stakeholder. I suspect patients will sympathize with the doctors who they believe always has the patient’s interest in mind. The doctors will sympathize with the patient who individually want no expense spared in their care. The doctors see themselves as victims of a system taking advantage of them. The organization will do what it takes to stay solvent so that they can employ the doctors and care for the patients.

And the one doesn’t understand the other.

No answers, just questions.

Image from DES Daughters