Hospital fund-raisers fear new restrictions on medical records privacy will cost institutions up to $3.5 billion over 12-18 months, jeopardizing programs and projects from scholarships to research to building. The shortfall could amount to about 40 percent of money raised in 2001.
The new regulations, which took effect yesterday, sharply curtail hospitals' ability to conduct target marketing because fund-raisers are forbidden access to patients' medical records without specific authorization.
Previously, for example, a hospital building a new cancer wing could choose to solicit money only from former cancer patients, not from all former patients.
But that would require access to medical records, and getting authorization for that presents all kinds of thorny ethical and public relations problems. Doctors and hospital administrators don't want to be viewed as capitalizing on patients' illnesses or tying fund-raising to patient care.
"You get your biggest income from targeted marketing because it pulls at the heart strings. Now the whole thing is getting awkward," said Susan Kind, senior vice president of development at Continuum Health Partners Inc., which operates four hospitals in New York City.
"Now we are just afraid people will say no when they hear fund-raising," Kind said.
Hospitals are still allowed to send out general fund-raising pleas, but the materials must give recipients the opportunity to opt out of future solicitations.
Hospital fund-raisers say they were always respectful of patient privacy and that their knowledge of a patients' condition never went beyond the most basic information.
The Association for Healthcare Philanthropy estimates hospitals could lose between $3 billion and $3.5 billion over the next 12-18 months. Final figures aren't available yet, but McGinly said indications are that hospitals raised more last year than the $8 billion they took in 2001. Almost 58 percent of donations come from individuals.
Hospital fund-raisers say their task already is harder because of the struggling economy.
Initially, Continuum wants 100 doctors with a known donor base to ask their patients on regular visits to sign authorization forms allowing their medical information to be used in fund-raising.
Doctors aren't thrilled about that approach, however. Sometimes a patient will ask about making a donation, but otherwise the doctor must decide if and when it is appropriate to bring up the subject.
"I certainly don't see myself bringing this up when they first come in," said Dr. Louis Harrison, clinical director of Continuum Cancer Centers for New York. "There is great risk of offending patients here, and that is something we don't want to do."
Last year, Johns Hopkins Medical Center in Baltimore raised $245 million in charitable donations, not quite 10 percent of its $2.6 billion annual budget.
The center is in the midst of raising $1 billion for two new research facilities and two replacement hospitals. It is experimenting with having patients sign authorization forms in outpatient clinics but will soon start asking for authorization when patients are discharged from the hospital.
"We are absolutely worried we won't be able to complete our plans," said John Zeller, associate vice president for development at Johns Hopkins Medicine.
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