Hospital as Predator

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A physician colleague recently went to the ER as a patient and posted the bill online. The laboratory charges totaled $1,092.83. My Direct Primary Care cash price for these exact same labs is $35. That’s a 97% savings! However, it isn’t actually a discount. My cash price is the REAL PRICE. The hospitals are the ones artificially inflating medical costs by over 3000%, which is truly horrific. Imagine preying on the sick and injured when they are at their most vulnerable and charging them over 30 times the actual price for the care they receive and then getting away with it since patients have no other option in an emergency. 

One of my Direct Primary Care colleagues told a heartbreaking story from when she was working for a hospital-owned primary care practice. One of her low-income patients, who was working full time in a minimum wage job with a high-deductible health insurance plan, brought in a bill for $800 for their last visit, which was a two-minute sick visit for a viral upper respiratory infection. This doctor’s name was on the bill, and she felt ashamed for her participation in the greedy actions of the hospital to add a hospital facility fee to every primary care visit just because the name of the hospital was on the building. Unfortunately, this is common practice.

In 2010, the ACA included a ban on physician-owned hospitals, which was supposedly done to protect patients from greedy doctors but was actually done to decrease competition for large consolidated health systems, many of which also own insurance companies and are unencumbered by pesky ethical principles. As expected, when these hospitals are compared to physician-owned hospitals, the best patient outcomes, quality care measures, lowest complication rates, and lowest costs are found in the physician-owned hospitals. What we really need in the Direct Primary Care movement is Direct Care Hospitals so that patients gain access to affordable emergency care.

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About Emily O'Rourke, MD

Dr. Emily O'Rourke started Fountain Direct Primary Care, the very first DPC practice in Hampton Roads, Virginia, in October 2018. She enjoys working with her patients on individualized treatment plans, including lifestyle modification, in order to transform their physical and mental health and help them achieve their goals and live more fulfilling lives. She also serves as an FAA Aviation Medical Examiner and performs Veteran Disability Examinations. Dr. O'Rourke was born and raised in the state of Nebraska, and she graduated with distinction from the University of Nebraska - Lincoln. She completed her medical education at the University of Nebraska Medical Center in 2010. She served as Chief Resident during her final year of the Eastern Virginia Medical School Portsmouth Family Medicine residency program. Dr. O'Rourke is Board Certified in Family Medicine through both the American Board of Family Medicine and the National Board of Physicians and Surgeons. Dr. O'Rourke lives in Chesapeake, Virginia with her husband, Jimmy, and their two sons, Logan and Jackson. She practices yoga regularly and enjoys creative pursuits, including crocheting and playing the cello.