Ethical bankruptcy of hospital management

Two law suits, one in Texas and the other in New Mexico, put the spotlight on the role of hospitals in employee or patient safety.

In New Mexico, Colleen Heild, my friend who is an investigative reporter at the Albuquerque Journal, reports U.S. Bankruptcy Judge Robert H. Jacobvitz ruled a hospital management company, in this case Quorum Health Resources, “breached its duty to prevent the risk of harm to dozens of patients of an Alamogordo hospital who were unwittingly subjected to experimental procedures to alleviate back pain.”

The other case, which may not see a ruling for quite a while, involves the Dallas-area nurse, Nina Pham, who contracted Ebola after caring for Thomas Duncan at Texas Health Presbyterian Hospital. Duncan later died. The Dallas Morning News broke the story over this past weekend and ProPublica placed Pham’s lawsuit in a broader context — the violation of patient privacy.

The behavior of the hospitals’ management in these stories triggered memories of my experience during the 1960s while attending the Hospital and Health Administration Program at the University of Iowa. And these cases brought to mind why hospital management can be so bereft of ethics. As part of the Iowa’s program back then, the department head, the late Gerhard Hartman, consulted with hospitals throughout the nation. Those engagements were the basis for the second-year masters students’ “community study,” the report and recommendations Hartman made to his clients.

Under the supervision of doctoral students, masters candidates would do all the research and writing of those reports. Sometimes the project involved traveling to the community, which the team members financed themselves. The community study team also paid for the report to be typed and then the university department copier would print the report for presentation.

I know that Hartman never reimbursed the graduate students for the expenses involved in the study. I doubt he reimbursed the university for using its resources as well. In the 1970s, there were rumors that Harman had double-dipped, billing the clients and university for the same services. No one, of course, stood up to him at the time. The price would have been too high. But it set the tone for the ethics in the department and I have often wondered over the years whether it set the tone for generations of hospital administrators who came through the Iowa program.