What Wall Street Doesn’t Want You to Know About Hospital Emergency Rooms

Yves here. We’ve written regularly on Eileen Appelbaum and Rosemary Batt’s important investigations into how private equity has taken over more and more of hospital staffing, including of emergency rooms. This in turn has allowed them to override patient efforts to have only in-network doctors assigned to their case, as well as to engage in other practices that greatly inflate patient charges (so-called surprise billing).

The legal fig leaf that allows private equity firms like Blackstone and KKR to play doctor is that their deals are structured so that  MD or group of MDs is the nominal owner of the specialty practice, even though the business is stripped of its assets and the operating contracts are widely believed to strip them of any say. The now-notorious incident of Blackstone’s TeamHealth firing whistleblower Dr. Ming Lin confirms who is really in charge.

By Eileen Appelbaum, the Co-Director of the Center for Economic and Policy Research and visiting professor, School of Management, University of Leicester, UK and Rosemary Batt, the Alice Hanson Cook Professor of Women and Work, Cornell University ILR School. Produced by Economy for All, a project of the Independent Media Institute

Doctor Ming Lin is the first emergency room doctor to be fired for going public with his concerns about poor hospital emergency room safety practices and shortages of medical supplies and protective gear for health workers. He won’t be the last.

Like many hospitals in the US, PeaceHealth St. Joseph Medical Center in Bellingham Washington, where Ming Lin worked for the past 17 years as an emergency room doctor, has outsourced the management and staffing of its emergency rooms. So, Lin works on-site at the hospital’s emergency room, but he is employed by a physician staffing firm that runs the emergency room. These staffing firms are often behind the surprise medical bills for emergency room services that patients receive after their insurance company has paid the hospital and doctors, but not the excessive out-of-network charges billed by these outside staffing firms.

About a third of hospital emergency rooms are staffed by doctors on the payrolls of two physician staffing companies—TeamHealth and Envision Health—owned by Wall Street investment firms. Envision Healthcare employs 69,000 healthcare workers nationwide while TeamHealth employs 20,000. Private equity firm Blackstone Group owns TeamHealth, Kravis Kohlberg Roberts (KKR) owns Envision.

Care of the sick is not the mission of these companies; their mission is to make outsized profits for the private equity firms and its investors. Overcharging patients and insurance companies for providing urgent and desperately needed emergency medical care is bad enough. But it is unconscionable to muzzle doctors who speak out to advocate for the health of their patients and co-workers during the global pandemic that is rapidly spreading across the US.

Yet, that is what Blackstone-owned TeamHealth just did. Why would an experienced emergency room doctor be fired in the middle of a pandemic? One clue may be that Blackstone’s CEO, Stephen A. Schwarzman, is part of President Trump’s inner circle. He may not want to risk that relationship by allowing TeamHealth’s doctors to inform the public about Washington’s mishandling of the allocation of supplies and protective gear. The President might conclude that TeamHealth doctors didn’t appreciate him enough, and where would that leave Schwartzman?

PeaceHealth St. Joseph Medical Center may have the distinction of being the first hospital to have a doctor outsourced from a physician staffing firm unceremoniously fired for telling the public the truth. But it won’t be the last. Hospitals are now telling doctors treating coronavirus patients they will be fired if they speak to the press.

The American Academy of Emergency Medicine protested Dr. Lin’s ouster and questioned how TeamHealth is allowed to provide hospital services when the law requires that physician practices must be owned by a licensed medical practitioner. TeamHealth skirts the law by owning all the assets of the physician practices it acquires—the real estate, offices, equipment, supplies, inventory, and even accounts receivable.

On paper, the physician practices are owned by a doctor-led organization that TeamHealth has set up to comply with the law. But what does it mean to own a physician practice if the practice has no assets and no possibility to exist on its own?

The furor over patients hit by surprise medical bills revealed that TeamHealth controls the billing for the doctors it supplies to hospital emergency rooms. The firing of Doctor Ming Lin pulls back the curtain and reveals that TeamHealth controls the doctors as well.

What Happens When Narcissists Get Old?

Understand WHY you want to know this. Maybe you are dealing with an ageing narcissist and feeling traumatised, because you are so tied into responsibility and duty to them. Or, perhaps you have been devastated by a narcissist, who seems to be having it all now, and you now wonder if the karma bus will strike as they age. This is normal … and TOTALLY understandable! But wondering and watching and still being hooked into the narcissist’s progress and results is SO not healthy for us. (I promise you very SOON you will understand WHY!) In today’s Thriver TV episode, I am excited to share with you the TRUTH about what is going on with narcissists as they age. And it’s my greatest desire that you will receive relief, closure and the added power to heal and move on into your True Self and True Life, as a result of today’s video. ⬇️

Colleges Challenge a Common Protection in Sexual Assault Lawsuits: Anonymity

The former college student said she had been raped three times as an undergraduate at Florida A&M University, twice by students and once by an acquaintance who was on campus regularly.

She withdrew from the university and filed suit, saying that campus officials did not do enough to investigate the claims and protect her from being attacked again and again. As a precaution, she identified herself in public court papers only as S.B.

Her school fired back three times with a demand for the court: Reveal her full name or toss out the case.

For years, students have filed sexual assault complaints under pseudonyms, which allow them to seek justice without shame or fear of being targeted. Universities have generally accepted the practice.

But in two recent lawsuits — S.B.’s case against Florida A&M University and a suit by nine women against Dartmouth College — the schools have demanded that students publicly reveal their identities, going against longstanding legal practice intended to protect plaintiffs in sensitive disputes.

Experts on sexual assault cases say that these demands amount to a newly aggressive stance by universities that face potentially damaging lawsuits, and that they run counter to the spirit of federal civil rights policies. The identities of the women in both cases are known to the university lawyers, but not to the public.

“What you’re seeing in this particular case is real hardball,” said Andrew Miltenberg, a lawyer who typically represents men accused of sexual assault. “And it’s still not the way most lawyers or schools handle it. They’re a little bit more gracious about protecting someone who was their student.”

On Wednesday, S.B.’s lawyer sent a letter to more than 40 state legislators objecting to the university’s tactics and asking them to investigate the matter.