Hospital trend worries doctors

Some Houston physicians say they can't always get what's best for patients

By Jace Larson - Investigative Reporter

HOUSTON - Several Houston doctors say a trend inside hospitals could keep you from getting the best care while you're there.

The doctors tell Local 2 Investigates that exclusive agreements between hospitals and suppliers are blocking them from getting better devices, medicines and other items for their patients.

"These contracting agreements go throughout the healthcare system," said Arthur Caplan, professor of bioethics at New York University's Langone Medical Center. "They're growing. They are ways the hospitals can save money."

Caplan says hospitals have many exclusive agreements for everything from specific brands of medical devices to certain medicines. If a doctor wants to use something different for a specific patient, many times the hospitals are telling doctors to take it or leave it, Caplan said.

"More and more it's going to be one size fits all," said Caplan. "Sadly, most of us don't understand what's going on."

Tasha Johnson found out how those agreements work after requesting the doctor's notes from her mother Helen's heart surgery.

"I literally collapsed on the couch after I read them," Johnson said.

Helen Johnson died 10 months after a Houston doctor implanted her second pacemaker. The doctor's notes outlined a major dispute between the doctor and the hospital when it came to what kind of pacemaker to install during surgery.

The notes show Helen Johnson's doctor wanted to implant the same brand of device as the first pacemaker, but the doctor says a Houston hospital blocked him and told him he had to use a pacemaker made by a different company instead.

"They have forced this policy against my best professional opinion," the doctor writes in his notes. "Hospital personnel told me categorically that they have some understanding with (a different brand) for cheaper devices. I do not understand why the administration wants to do it this way."

"I felt like she meant nothing," said Tasha Johnson. "It was all about the dollar."

Local 2 Investigates heard stories from 10 doctors in Houston about similar disputes. Each doctor said he or she tried to use something they thought was best for a patient, but couldn't use it because it wasn't on the hospitals approved list. The doctors didn't want their names used because they said they were afraid of how the hospitals might react.

One doctor spoke about a stomach cancer patient who needed a specific nutritional formula but was forced to use a different one. The new formula made him sick. Another doctor said his hospital changed to a new kit for spinal tap procedures. The new kit had various side effects, but the doctor says the hospital refused to go back to the old kits.

Another physician said a dispute could be as simple as not being able for you to get your usual medicine while in the hospital. For example, if you always use Prilosec for heartburn, you might be stuck using another medicine like Nexium during your stay because that's what stocked at the hospital.

"We need more light and transparency about this because at the end of the day, if a patient wants the best care possible, it's something the patient has the right to know," Caplan said.

Both hospitals and doctors say price isn't the only deciding factor when making agreements with suppliers. Hospitals said administrators work with physicians to choose the best medical option for the most people. No facility can have every brand of device, medicine or procedure kit available, hospitals say.

Some medical ethics experts say doctors may be making certain decisions on what device or drug to use because they're being paid consultant fees. The experts say the potential conflicts can go both ways.

So what can you do as a patient? Caplan suggests to ask your doctor if anyone is requiring him or her to use a certain brand of device, medicine, etc. Ask if the doctor is a paid consultant for any company. If there is some sort of dispute, ask your doctor what your options may be, including paying more for something different or moving to another hospital.

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