The Very Real Dangers of For-Profit Healthcare

A closer look at how corporate-run for-profit healthcare facilities are detached from the patients and communities they serve.

For-Profit Health Care – The Dangers for Nurses & Patients

As a nurse, I have noticed how detached for-profit healthcare is. Decisions are made for the bottom dollar and not the people in the hospital beds.

My Experience As A Nurse in a For-Profit Healthcare Hospital

My nursing career started in a private for-profit corporate hospital. As nurses on the floor, we were governed by decisions and rules made by distant administrators in their fairy tale corporate castles. They had little to no interests in our community. They didn’t live there. They didn’t know the unique challenges and cultures that impacted the care we provided and needed the ability to provide. Decisions almost always felt like they were made from the benefit of the company as a whole rather than the patients and the communities that the hospitals serve. The administrative process always felt detached to me with middle management, and even CEO’s often throwing their hands in the air and always having “corporate” as the answer to all the tough questions.

Some Tough Questions To Administrators of For-Profit Healthcare Facilities

I have some questions for the people that make budget decisions in for-profit healthcare facilities. These are real concerns from me – a nurse – who is on the floor with the patients.

• Can we improve our patient experience by getting more efficient and comfortable IV equipment?
• Can we look into ways to getting our documentation to be more efficient to improve patient care?
• Why are you taking shift differentials away from LPN nurses without grandfathering them into the new salary plan?
• How can the hospital afford to do $10 million renovation and facelift (complete with fountain and towering glass facade and foyer) when you just took away the nurses’ retention bonus due to “budgetary and economic concerns”
• Can we do a fundraiser to benefit –insert local organization or cause here-?

For-Profit Healthcare Instills Fear of An Invisible Corporate Hand

The administrative culture seemed to be one of fear of the invisible corporate hand. There was no transparency, little accountability, and questions were often pushed aside because the local administrators were simply “doing what they were told.” I can recall several times being told “this is from a higher authority from me” and sensing the frustration and disappointment that my direct manager and hospital leaders were battling themselves. They were not the ones to blame for the changes but they were the ones who had to be accountable with no one else to turn to themselves. Corporate, after all, are in another state and this is a decision passed down universally. They really don’t care what we think, they’ve made their decision and we have to follow it.

The focus of the corporate for-profit hospital always seemed to be about the organization. It never felt like the patients and the communities were at the center of any decisions made.

What Corporate For-Profit Health Care Is Asking

As a nurse, this is what it feels like the for-profit healthcare administrators are asking when they make decisions for the hospitals:

• What is best for the company?
• How can we deliver patient care to deliver the most profitable results?
• How can we be compliant with regulations, while investing as little as possible in new technologies and community-specific needs?
• How can we make our shareholders as rich as possible while ignoring the needs of individuals in the hospitals we own?

What Should For-Profit Healthcare Be Asking?

I suggest they refocus on the people in the hospital. They need to be asking these questions instead.

• How can we better serve the communities we have a presence in and remain profitable?
• How can we deliver the best possible healthcare and quality of life to the preserve we server and the healthcare providers we employ?
• How can we value each facility independently and allow autonomy and natural growth and progress within their respective communities?
• How can we make the world a better place?

For-Profit Healthcare Needs Reworked

Any good hospital has to be run on a business model, but that cannot be its primary focus in order to function well for the community it serves. A good hospital has to have people, and ideally, an entire community at the heart of its focus. They need to be profitable to the communities they serve.

The decisions that are made that affect patients and healthcare providers should not come down from some mystical far away unapproachable corporate land. Decisions that effects healthcare of entire communities should be by people who live in those communities.

Decision makers should have to lie in the beds that they make. Even a pig doesn’t poop where it sleeps. If decisions in healthcare were made where the decider is directly impacted by their decisions, then we’d likely see a greater amount of compassion and care in healthcare systems.

Community Not For Profit Healthcare Benefits

Community hospitals and health systems have a greater interest in the community they serve because they live in that community. Decisions that are made that affect patient care are made with the awareness that those decisions could impact care that you, your neighbor, or your family receive. There is a much greater weight placed on decisions when you see and feel the impact of them immediately and right in front of you. The need for accountability and transparency are understood as a vital role for the success of the healthcare organization and the community overall.

An efficient community not-for-profit hospital that runs well while appropriately serving a communities needs will often generate a profit. However, instead of adding to the surplus wealth of investors and shareholders they use that again to invest in the community. They enrich the lives of the people that they take care of. They add wealth and value to the lives of many rather than the bank accounts of a few.

Community not-for-profit healthcare facilities invest in better technologies sooner and promote innovation and change with greater enthusiasm. Conversations at meetings are based upon the needs of the community and patients rather than the restrictions of a budget. It feels like the hospitals have a greater focus on caring and compassion and almost as if they following a nursing process to patient care. The focus is a holistic approach to a community rather than just within the hospital walls.

Making Your Bed in Healthcare

Decisions that impact healthcare should be made by those who will receive that healthcare. If you have to lie in the bed you make, you’re probably going to make a much better bed. Perhaps some old school nurses can step up to the plate and show some folks how to make some hospital corners?

Nurse Resources

Now that you know something about the dangers of for-profit healthcare, here are some more resources that will help you in your career in nursing.

• Eliminate Paper and Improve Patient Care Across the Continuum with Tracked Clinical Competencies
• What is Nursing Informatics?
• Why Nurse Empowerment is Important for the Future of Healthcare