In some ways, the three types of hospitals are quite different. In other ways, they are very much the same.<\/p>\n
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.<\/p>\n
The first incorporated hospital in what would become the United States was the Pennsylvania Hospital, which was chartered in 1751.<\/p>\n
New York City has eleven public hospitals and roughly three dozen clinics, ambulatory (emergency) care facilities, and other smaller facilities.<\/p>\n
Public health facilities receive almost all their funding from the city, county, or other governmental entity which owns them.<\/p>\n
Patients never pay anything for healthcare. Occasionally, public hospitals ask Medicare or Medicaid for reimbursement.<\/p>\n
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.<\/p>\n
Most hospitals are private, for-profit hospitals. Like Amazon, Walmart, and the hot dog vendor on the corner, private hospitals are investor-supported.<\/p>\n
These hospitals distribute their profits to investors as dividends.<\/p>\n
As mentioned, these facilities try to maximize profits in order to attract investors. Most other public corporations do the same thing.<\/p>\n
As a result, private for-profit hospitals often focus on high revenue areas, such as elective heart surgery and labor\/delivery services.<\/p>\n
Most religiously affiliated hospitals are private nonprofit hospitals.<\/p>\n
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.<\/p>\n
These reinvestment guidelines vary significantly in different areas. In some places, \u201ccommunity reinvestment\u201d could mean almost anything, including advertising and marketing.<\/p>\n
Other places limit this area to things like holding seminars and opening satellite clinics.<\/p>\n
All three types of hospitals are money-making institutions, at least indirectly.<\/p>\n
A government will close a public hospital without much hesitation if it costs too much.<\/p>\n
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.<\/p>\n
In terms of health and safety, doctors have a fiduciary duty<\/a><\/u> toward their patients.<\/p>\n Doctors must cast all other considerations aside and do what is best for their patients.<\/p>\n Anything less constitutes negligence, or a lack of care.<\/p>\n The beginning point of the doctor-patient relationship is controversial.<\/p>\n 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?<\/p>\n Is there a fiduciary duty even though no money changed hands? Or what about doctors who volunteer their time on weekends? Does New York\u2019s Good Samaritan law apply or not?<\/p>\n Misdiagnosis<\/a><\/u> is a good example of how the fiduciary duty works in practice.<\/p>\n Nationally, the misdiagnosis rate is about 20 percent.<\/p>\n A doctor who fails to properly diagnose one in five patients is almost certainly negligent.<\/p>\n 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. <\/u><\/p>\n Foreseeability<\/a><\/u> is the key word here.<\/p>\n 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.<\/p>\n 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.<\/p>\n Negligent security incidents, such as an assault in a parking garage, work a bit differently.<\/p>\n 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<\/a><\/u> to prove if the facility was in a high-crime area.<\/p>\n Damages in these cases usually include compensation for economic losses, such as medical bills, and noneconomic losses, such as pain and suffering.<\/p>\n In medical malpractice claims, additional punitive damages are usually available as well, because of the higher duty of care.<\/p>\nPremises Liability<\/h4>\n