Your Health. Your Choice.
Advocating For Health Care That Puts Patients First
When Medicine Becomes Big Business
Medicine is increasingly becoming big business. As the large health care companies buy up hospitals, local clinics, and individual medical practices, the focus can change from what is best for patients to what makes them the most money. To them, you are no longer a patient, but a commodity they believe they own.
What Are Leakage Reports?
One way these large health care organizations try to maximize revenue is by pressuring their doctors to ONLY REFER patients to other doctors who work for the same corporation. They produce monthly “Leakage Reports” to identify and monitor doctors who chose to refer patients outside of their system. It doesn’t matter if the doctor thinks an outside referral is better for the patient—the large corporations consider any referral to a doctor outside their system to be “leakage,” and that’s frowned upon. This pressure has nothing to do with getting the best care for you or your needs; it is 100% focused on maximizing the corporation’s revenue.
Their goal is to ensure all of your health care dollars go to their medical corporation.
Fear drives this referral behavior because your doctor is afraid of the negative consequences that may arise from referring outside of the “system” when they get their next “leakage report.” This could be as explicit as having a direct effect on their compensation based on the percent leakage, or as subtle as not being viewed as a “team player” when it comes time to renew their contract. Either way, the fear of “leakage” is changing the referral behavior because no one, doctors included, wants to risk losing their job. You come out on the short end of this because the referral is not necessarily based on what is in the best interests of the patient (you), but instead based on what serves the doctor’s best interests.
They may refer you to a stranger. Historically doctors have always referred their patients to specialists they know and trust from years of collaborating together on patient care. But now, doctors who work for big Washington health care systems are pressured to refer you to other doctors who work for the same corporation, even if they have never met them.
Your insurance gives you the right to choose and you can get your care from any provider contracted with your insurance company (even one that is not, but it will cost you more). You are not required to go where you are told by the doctor making a referral. They may even tell you that they won’t refer you to anyone locally—how is that in your best interests?
How To Get The Best Care 
Exercise Your Right To Choose Your Doctor
Ask For Alternatives
Your doctor should give you alternatives to choose from within the Washington health care system. If they only refer you to doctors who work for the same big medical conglomerate, you have the right to ask for other options.
Do Your Homework
Be Comfortable
When you meet with a doctor, you should feel 100% comfortable with them, their staff, their clinic setting, and their office location. If these criteria are not met, then you should look somewhere else. There are dozens of fantastic doctors close to where you live who will be “just right.” Many of the best doctors have rejected “big corporate medicine” and are practicing independently, or with other doctors who share a passion to ensure the best care possible for their patients.
Cost Savings for You
Most independent specialists work with outpatient therapy and surgery centers where overhead costs are much lower than in the big corporate medical hospitals. Like most people, you probably have a large deductible on your medical insurance. You can save a lot of money by getting care from an independent, non-hospital affiliated specialist. Savings of 50% or more are common.
Reduce Your Risk
Many big institutional medical facilities that deal with sick patients and serious diseases are unfortunately plagued by nosocomial and life-threatening infections like MRSA, Staphylococcus aureus, E. coli, Pseudomonas aeruginosa, among others. This problem is so common (about one in ten hospital patients get infected) that there’s an acronym for it—HAI (Hospital-Acquired Infection). The good news is that the incidence of these infections is nearly non-existent in independent, local day-surgery facilities and their associated clinics. The smaller, independent practices won’t just save you money, they may save your life.