Are You A Person Or An URP (Unit of Revenue Production)? Part 1

I have been treated at different medical centers and by different physicians over my life. I also have been able to observe clinical care as an observer when I have taken family and friends to the hospital.

I feel that care can be delivered either by viewing the individual who has come seeking medical attention as a human being (what I describe as the Mayo Clinic Model) or, sadly, as merely a way to make more money for the hospital or physicians. I describe the latter approach to medical care delivery as viewing people not as human beings, but, instead, as URPs, or Units of Revenue Production.

Human being needs to be treated with the highest level of clinical excellence while making sure that they are treated with as much respect and dignity as possible while they receive medical attention. Many mornings I drink out of a Mayo Clinic mug which has the Clinic's motto written on it. Mayo's primary value is that "the needs of the patient comes first." See the Mayo Clinic Mission and Values here.

I think that one of the reasons that Mayo is able to be so successful at treating people well is because their physicians are paid a set salary so they can spend the time necessary with each person to treat them appropriately. They don't get additional salary for hitting revenue and volume targets dictated by some number cruncher from hospital management. 

Then there are medical centers and physicians who focus on what is best for them and their bottom line. One situation where this is particularly problematic is when a new procedure or technique has become adopted in a particular medical specialty which creates better results for patients. Physicians who are "early adopters" are able to treat their patients as soon as a better mode of treatment is available. Then there are physicians who continue to use the old procedure even at increased risk to the patient relative to the new procedure.

Case and point: When either procedure is medically ok to perform, should a urologist who only removes kidneys the old-fashioned method - through surgery - let his patient know that the kidney could be removed laproscopically and that the laproscopic procedure correlates with a much quicker and easier recovery? Does he have a duty to inform his patient? If you view the patient as an URP, then the urologist will just go ahead and perform the procedure. If the Mayo Clinic Model is used, then the urologist will inform the patient of the risks and benefits and encourage the patient to do what is best for the patient.

More on this issue later....

(FYI, here are some of the hospitals I have been at...mostly as a visitor and not as a patient: The Mayo Clinic and its 2 hospitals - St. Mary's and Rochester Methodist; Mount Sinai Hospital in Miami; Kaplan Hospital in Rehovot, Israel; Jesse Brown VA Hospital in Chicago; and many other Chicago Hospitals including Loyola; Northwestern; Children's Memorial; Evanston; Skokie; Highland Park; Glenbrook; Swedish Covenant; St. Francis; Northwest Community; Lutheran General; Holy Family; and many others...)