Healthcare News of Note: Nurses, doctors and pharmacists rank highest in Gallup’s latest ethics poll

• Although nurses, medical doctors and pharmacists recently garnered the highest ethics rankings among 18 professions in a consumer poll, each group’s ratings have fallen over the past two years.
• There are now at least 15 private-equity-backed management companies that own orthopedic practices across the country.
• A substantial reduction in the odds of 30-day use of acute care resources was seen when a text-message-based automated system was used to monitor patients after hospitalization.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.    

1. Nurses, doctors and pharmacists earned the highest ethics rankings in the latest Gallup Poll

Although nurses, medical doctors and pharmacists recently garnered the highest ethics rankings among the 18 professions that were ranked, each group’s ratings “dropped significantly in 2021 and edged down further this year,” according to a Jan. 10 Gallup news article.

“In addition to the three healthcare-related fields, just one other profession is held in high regard among a majority of Americans — high school teachers, who are rated highly by 53% of U.S. adults,” wrote the article’s author, Megan Brenan.

The article is based on data from telephone interviews — conducted Nov. 9-Dec. 2 — with a random sample of 1,020 U.S. adults, who were asked to rank the honesty and ethical standards of various professions. The ranking choices were “very high,” “high,” “average,” “low” and “very low.”

“Nurses continue to garner the highest ethics rating from Americans among a diverse list of professions, a distinction they have held for more than two decades,” wrote Brenan.

Rankings continued to dip in 2022

Some 79% of U.S. adults gave nurses a “very high” or “high” rating for their honesty and ethical standards, which Brenan noted “is far more than any of the other 17 professions rated.” Nurses finished 17 percentage points above the next highest ranked group: medical doctors, at 62%.

“Still, the current rating for nurses is 10 percentage points lower than the highest rating for nurses, recorded in 2020, when they were on the front lines of the COVID-19 pandemic and their ethics ratings soared,” wrote Brenan.

All three medical professions in 2022 saw ratings “below their pre-pandemic levels,” wrote Brenan. Ratings for both medical doctors and pharmacists fell five percentage points from 2021.

Findings for the past three years

Results of the Gallup polls conducted in the past three years tell the story of plummeting ratings:         

• Nurses fell from 89% in 2020 to 81% in 2021 and 79% in 2022.
• Medical doctors dropped from 77% in 2020 to 67% in 2021 and 62% in 2022.
• Pharmacists declined from 71% in 2020 to 63% in 2021 and 58% in 2022.

2. More orthopedic practices are selling to private equity firms

Independent orthopedic surgeons are following dermatologists and ophthalmologists “in selling control of their practices to private equity investment firms,” according to a Jan. 6 Kaiser Health News (KHN) article.

“They hope to grab a bigger chunk of the surging market in outpatient surgery and maintain their position as one of the highest-paid specialties in medicine — $633,620 was the average compensation for orthopedists in 2021,” wrote author Harris Meyer. “For older doctors, the upfront cash payout and the potential second payout when the business is flipped offers the promise of a posh retirement.”

Gary Herschman, a New York attorney, was quoted in the article, saying: “There are now at least 15 PE-backed management companies — called platforms — that own orthopedic practices across the country. The first orthopedic deals were done in 2017, and dozens of sales have occurred since then, with the pace expected to quicken. In 2022 alone, at least 15 orthopedic practices were sold to PE-owned management companies.”

Pros and cons

How this plays out for patients is still unknown, but Meyer points out several pros and cons, including:

Pro. “Private equity investment has the potential to reduce total spending on musculoskeletal care and improve quality by helping physicians move more procedures to cheaper outpatient surgery centers, which have less overhead.”

Con. “But critics warn that profit-hungry private equity ownership alternatively could result in higher prices for patients and insurers, more unnecessary surgery, and less access to care for patients on Medicaid or those who are uninsured or underinsured.”

Relevant HFMA articles

The industrywide trend for such sales has been on the upswing, and that will continue this year, according to articles in recent issues of hfm:

• A November 2022 article, authored by healthcare attorney Gary Bruce, stated: “According to Bain & Company, a leading consultancy headquartered in Boston, the number of PE deals in the healthcare sector is skyrocketing. Bain found that PE investors closed 515 deals with an aggregate value of $151 billion in 2021. These numbers dwarf the 380 deals worth $66 billion that closed in 2020.”
• “Increased optimism among private investors” was the second point highlighted in Paul Keckley’s Winter 2022-23 hfm column, “3 trends to watch for in the 2023 healthcare regulatory agenda,” where he wrote: “In 2023, private capital deployment by nontraditional players will take advantage of incumbent financial insecurity and increase their footprint in key sectors of delivery and financing.”

3. Less use of acute care resources was seen for patients who received automated text messages post-discharge, study finds

A 41% reduction in the odds of 30-day use of acute care resources was seen when a text-message-based automated system was used to monitor patients after hospitalization, according to a study published Oct. 26 in JAMA Network Open.

Study authors said the results suggest that “a 30-day automated texting program can improve post discharge outcomes among primary care patients.

“This outcome was driven largely by a 55% decrease in the odds of a 30-day readmission,” they added. They theorized that “more frequent check-ins and a lower friction medium for patient-initiated outreach lead to earlier identification of needs and a greater likelihood that issues will be escalated to and handled by the primary care practice than another setting.”

The study cohort consisted of patients who were 18 years or older and regularly were seen at two practices based in Philadelphia. Upon discharge from the hospital, one set of patients received “the usual transitional care management telephone call” while the other group “received automated check-in text messages from their primary care practice on a tapering schedule during the 30 days after discharge.”

Additionally, for the second group, “any needs identified by the automated messaging platform were escalated to practice staff for follow-up via an electronic medical record inbox,” wrote the authors.

HFMA bonus content

• Read HFMA National Chair Aaron Crane’s latest column: “HFMA launches DEI task force.”
• Listen to “Beyond automation: Fulfilling your New Year’s resolution for a more efficient revenue cycle,” with special guest Jonathan Wiik of FinThrive discussing revenue cycle improvement strategies with Voices in Healthcare Finance podcast host Erika Grotto.
• Read the hfm article “Bringing ESG principles to healthcare,” written by HFMA’s Nick Hut, senior editor.