The Intersection of Corporate Medicine and Diversity, Equity, and Inclusion: Strengthening Prohibitions and Prioritizing Employee Well-being

The Intersection of Corporate Medicine and Diversity, Equity, and Inclusion: Strengthening Prohibitions and Prioritizing Employee Well-being

Introduction:

In today's ever-evolving healthcare landscape, the corporate practice of medicine (CPOM) has become a prevalent concern. Despite the existence of CPOM laws in many states, corporate entities continue to exert control over clinical operations, management decisions, and billing practices in healthcare settings. This article explores the reasons behind the persistence of corporatization in healthcare and proposes strategies to strengthen prohibitions against it. Additionally, we will discuss the importance of incorporating diversity, equity, and inclusion (DEI) initiatives within corporate healthcare settings and their impact on employee well-being.

The Influence of Corporate Entities in Healthcare:

With the rise of highly leveraged and multilayered deal structures, corporate investors in healthcare now possess greater market power and pursue aggressive revenue models. As a result, they are more insulated from risk compared to traditional health maintenance organizations. Today, approximately three-quarters of physicians in the United States are salaried employees, with half of all physician practices owned by hospitals or corporate entities. This corporate land grab in healthcare raises concerns about the erosion of the medical profession's autonomy and the impact on the public interest.

Risks Posed by Corporatized Medicine:

Emerging evidence highlights three primary risks associated with corporatized medicine. Firstly, market consolidation and exploitation of payment loopholes lead to increased healthcare prices and spending. Secondly, changes in practice patterns and pressures to reduce staffing raise concerns about patient care quality. Lastly, physicians experience moral injury and burnout due to the influence of corporate entities on their clinical decision-making.

Challenges in Enforcing CPOM Laws:

While CPOM laws exist in various states, they have not been entirely effective in preventing corporatization. One reason is the use of management-services agreements, which enable corporate entities to bypass restrictions on corporate practice. Additionally, stock-restriction agreements, noncompete clauses, and nondisclosure agreements further solidify corporate control over physician-owners and limit their autonomy.

Strengthening Prohibitions against Corporate Practice of Medicine:

To safeguard the medical profession and public interest, it is crucial to address the existing loopholes and enhance prohibitions against corporate ownership. One approach is to close the gaps that permit corporate ownership, such as the case in Oregon, where limited-liability companies and partnerships can deliver medical services without meeting physician-ownership requirements. Ensuring ultimate control by licensed professionals is essential to preserve the integrity of healthcare delivery.

The Intersection of DEI and Corporate Healthcare:

While addressing the challenges posed by corporate medicine, it is equally important to prioritize diversity, equity, and inclusion within healthcare organizations. In recent times, economic uncertainty and legislative efforts have slowed down DEI initiatives. However, it is crucial for companies to recommit to these efforts, considering the impact on employee engagement and well-being.

Prioritizing Employee Well-being through DEI:

Gallup estimates that 77% of employees are unengaged at work, leading to increased worker stress and significant economic costs. By prioritizing DEI initiatives, healthcare organizations can create an inclusive environment that fosters employee engagement, reduces stress levels, and improves overall well-being. This, in turn, positively impacts patient care outcomes.

Actionable Advice:

• 1. Strengthen CPOM Laws: Advocate for comprehensive legislation that closes existing loopholes and prevents corporate entities from exerting control over clinical operations. This will help protect the autonomy of the medical profession and ensure the public's best interests are served.

• 2. Prioritize DEI Initiatives: Encourage healthcare organizations to recommit to diversity, equity, and inclusion efforts. Implement policies that promote equal opportunities, address unconscious biases, and create inclusive environments that foster employee engagement and well-being.

• 3. Support Physician Advocacy: Empower physicians to advocate for their autonomy and the integrity of healthcare delivery. Provide resources and platforms for physicians to voice concerns, share experiences, and collaborate with policymakers to strengthen prohibitions against the corporate practice of medicine.

Conclusion:

The corporate practice of medicine continues to present challenges to the medical profession and the public interest. By strengthening prohibitions against corporate ownership and prioritizing diversity, equity, and inclusion initiatives, healthcare organizations can create a more balanced and equitable healthcare system. Taking action to protect the autonomy of physicians and improve employee well-being will ultimately lead to better patient care outcomes and a more resilient healthcare industry.