In some ways, the three types of hospitals are quite different. In other ways, they are very much the same.
For one thing, they all have a duty to treat patients, regardless of their ability to pay. Additionally, they all have the same legal responsibilities in terms of patient safety.
The first incorporated hospital in what would become the United States was the Pennsylvania Hospital, which was chartered in 1751.
New York City has eleven public hospitals and roughly three dozen clinics, ambulatory (emergency) care facilities, and other smaller facilities.
Public health facilities receive almost all their funding from the city, county, or other governmental entity which owns them.
Patients never pay anything for healthcare. Occasionally, public hospitals ask Medicare or Medicaid for reimbursement.
Public hospitals generally treat many trauma patients. Since these services are rather unprofitable, many private hospitals do not offer them, or at least do not feature them prominently.
Private For Profit
Most hospitals are private, for-profit hospitals. Like Amazon, Walmart, and the hot dog vendor on the corner, private hospitals are investor-supported.
These hospitals distribute their profits to investors as dividends.
As mentioned, these facilities try to maximize profits in order to attract investors. Most other public corporations do the same thing.
As a result, private for-profit hospitals often focus on high revenue areas, such as elective heart surgery and labor/delivery services.
Most religiously affiliated hospitals are private nonprofit hospitals.
These facilities enjoy generous tax breaks. They generally pay no income, property, or other taxes. In return, these hospitals must reinvest all profits into the surrounding community.
These reinvestment guidelines vary significantly in different areas. In some places, “community reinvestment” could mean almost anything, including advertising and marketing.
Other places limit this area to things like holding seminars and opening satellite clinics.
All three types of hospitals are money-making institutions, at least indirectly.
A government will close a public hospital without much hesitation if it costs too much.
Nonprofits must offer competitive salaries, and investors will not invest in a hospital that loses money. Additionally, all three types of hospitals have the same safety responsibilities under New York law.
In terms of health and safety, doctors have a fiduciary duty toward their patients.
Doctors must cast all other considerations aside and do what is best for their patients.
Anything less constitutes negligence, or a lack of care.
The beginning point of the doctor-patient relationship is controversial.
The fiduciary duty obviously applies to regular patients in regular facilities. But what if someone asks a question at a nonprofit-sponsored community health seminar?
Is there a fiduciary duty even though no money changed hands? Or what about doctors who volunteer their time on weekends? Does New York’s Good Samaritan law apply or not?
Misdiagnosis is a good example of how the fiduciary duty works in practice.
Nationally, the misdiagnosis rate is about 20 percent.
A doctor who fails to properly diagnose one in five patients is almost certainly negligent.
All New York property owners, including public and private hospital owners, must protect patients, employees, and visitors from falls, security-related injuries, and other such issues.
Foreseeability is the key word here.
Floor hazards, like spills, uneven flooring, and loose handrails, cause most slip-and-fall injuries. If the injury is foreseeable, the owner has a duty to prevent it.
Foreseeable does not mean inevitable or even likely. Instead, foreseeable basically means possible. Falls are possible, so owners must take reasonable steps to prevent them.
Negligent security incidents, such as an assault in a parking garage, work a bit differently.
Generally, these injuries are foreseeable if a similar incident recently occurred at the hospital or in the general area. Foreseeability is easier for an attorney to prove if the facility was in a high-crime area.
Damages in these cases usually include compensation for economic losses, such as medical bills, and noneconomic losses, such as pain and suffering.
In medical malpractice claims, additional punitive damages are usually available as well, because of the higher duty of care.
All hospitals have safety responsibilities. For a free consultation with an experienced personal injury lawyer in New York, contact Napoli Shkolnik, PLLC. You have a limited amount of time to act.