As you consider whether to use a small regional hospital for surgical or other procedures, you need to be aware that many of these facilities are not “hospitals” in the way we normally think of them. That is, they lack important capabilities such as emergency rooms, a doctor on-site 24 hours a day or sophisticated resuscitation equipment. There are approximately 140 of these small (usually 10-20 bed) facilities around the country which are generally owned and run by a small group of doctors. Critics contend that the doctors are setting up these facilities to enable them to pick only the most profitable patients for care. Procedures involved can include plastic surgery, back surgery, heart surgery, etc.
The problem is that if something goes wrong, these facilities may not be able to provide the care you need to survive. In one recent Texas case, a patient who had undergone spine surgery developed breathing difficulties during the night. The nursing staff became concerned (there was no 24 hour doctor) and had to call 911 to transfer the patient to a full-service hospital. He died shortly after arrival. According to Medicare’s review of state records, that hospital had called 911 to transfer patients 15 times in the last two years.
In Portland, Oregon, another patient in a small doctor-owned hospital received too much pain medicine after back surgery. The staff had to call 911 to transfer her to a bigger hospital. She also died due to lack of timely emergency medical care.
In many cases, the cost of a full-service hospital is not any more than you would pay at these smaller facilities. Make sure you ask appropriate questions such as: is there a doctor here 24 hours a day, do you have an emergency room, etc. Do this before you agree to use the small facility. What may be beneficial (profitable) to the physician may not be beneficial to you.