Dictating care

Bill Toland's Dec. 26 article ("Doctors' Flight Leaves Patients in the Lurch") describes just one of the problems both patients and doctors face as more doctors are employed by large hospital systems and the doctors sign contracts that are more business-oriented than patient-oriented.

In this particular case the doctors have signed noncompete contracts which force the doctors to relocate their practices while giving no thought to the patients the move affects.

A recent New York Times article (Nov. 30) pointed out other disturbing trends when doctors are employed and under contract to large systems. When the hospital has too much power "the system can dictate which tests to perform, how much to charge and which patients to admit."

The national and regional trend has been to employ more physicians in large systems. There is no proof that this lowers costs or improves care.

Neither patients nor doctors want care dictated by nonphysician hospital administrators.

JOSEPH E. IMBRIGLIA, M.D.
Pine
The writer is clinical professor of orthopedic surgery, University of Pittsburgh.