Pratt Med's business model degrades patient care

Patrick and Robin Assouad

Date published: 7/21/2006

"First, do no harm" is supposed to be a physician's mantra. But just as there are sins of commission and omission, failure to act or respond can cause harm.

Pratt Medical Center's business model is based on a simple, yet very lucrative, idea. Simply put, Pratt accepts as many new patients for managed care as it can get. Of course, with each patient who selects a Pratt physician as his or her managed-care M.D., Pratt management collects a monthly insurance stipend.

Pratt management then requires its physicians to see as many of those patients per hour per day per month as they humanly can. More often than not, office appointments for serious illnesses are not possible in any realistic and humane time frame.

Note: Regardless of whether a patient actually gets to see his physician in any given month, Pratt management keeps the monthly insurance stipend.

The problem with this business model is that far more patients (and monthly insurance fees) have been collected by Pratt than its physicians can possibly treat. Pratt physicians are overloaded, and patient care obviously suffers.

Pratt management makes a lot of money, so the situation is just fine to it. Why should Pratt management bother to act or respond to the situation?

Pratt is of course a business, and, like all businesses, it must make a profit. However, Pratt's business is supposed to be treating sick patients--not just collecting monthly insurance stipends. Making a reasonable profit should be possible without overloading physicians and harming patient care.

"First, do no harm." Doing nothing to change Pratt's business practices is a sin of omission and is causing real harm to patients.

Patrick and Robin Assouad

Falmouth

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Date published: 7/21/2006