The revamped recertification process sounds a lot more appealing and relevant than what I endured the last nine months. I would have appreciated a clear recognition of this reality from Dr. Dantzker rather than a defensive stance. Hospitals need to expand their outlook if they are going to succeed in a practice environment that has a growing elderly population and an increased prevalence of chronic diseases. This healthcare climate requires hospitals to pay attention to more than just physician practices' hospital admission rates, clinic income and revenue from ancillary service referrals. While hospitals have many successes treating acute illness, they generally have a poor track record managing chronic disease in the outpatient setting.
Financial success involves more than preoccupation with patient volume, revenues and referrals.
It requires an appreciation of the human condition in context, one that takes into account the physical and psychosocial variables that affect the course and outcome of chronic medical disorders. It also requires administrators to listen to experienced clinicians about the value of outpatient programs that change patients' lifestyles and improve care quality. Active interventions to prevent hospitalization have become an important trend in outpatient practices. Perhaps this threatens hospital managers concerned only about census figures and practice volumes, and not the true health of the communities they serve. While chronic disease programs do not produce immediate profits, they are necessary to broaden and enhance patient care and, in time, an institution's reputation.