Last week, one organization announced a Fortune 500 research report for a hospital CEO forum. They highlighted the 5 most dangerous trends facing hospitals and predict a 150,000-200,000 bed shortage by 2012 due to profitability issues. I usually take these kind of reports with a bucket of salt, since "research" and data can be spun in whatever way we'd like. Nonetheless, here are those 5 trends and my comments on each:

1) Bottom line performance is not improving. Efficiency and cost cutting policies are not working. While hospitals have been going out of business at a rate of one hospital every 8 days for the last 30 years, the bankruptcy trend has started to accelerate in 2005. (this might be true, but what about new hospitals opening up? Also, what about the fact that hospitals, on the whole, have reached a 6-year high in terms of profitabiltiy?)

2) Cutthroat competition to our medical centers include medical tourism. Medicare and Medicaid recent reimbursement reductions have made it harder for medical centers to survive. Competition from diagnostic testing facilities, ambulatory surgery centers and specialty hospitals are growing at record rates. India has recently become an early threat with two hospitals that have been approved by the JCAHO. (Medical Tourism is a hot topic; though growing, it still only represents a fraction of a percent. Medicare/Medicaid pressures are real, and so are the specialty hospital threats - though this will probably be reigned in by legislation)

3) Public is losing confidence in our hospitals. 35% of patients indicate a likelihood of not returning to the same hospital. 41% wouldn't recommend a hospital to their family. (This may be a problem for particular hospitals, but it's not like patients can boycott the only hospital in town?)

4) Staff satisfaction is low. Nursing shortage of more than 1 million nurses as well as significant. shortages in pharmacists, lab technicians, and other technical employees are expected by 2010. The hospital working environment is a key contributor to the 20% average burnout and staff turnover. (Can't argue with this one, though chances are, I suspect we will continue to see an influx of foreign-trained healthcare professionals as our training/education system slowly adjusts)

5) Lawsuits are on the rise. Medical malpractice has grown at an annual rate 30% faster than for all U.S. tort cases. The average malpractice settlement more than tripled from $95,000 in 1986 to $320,000 in 2002. (can't argue with this one either, though we have to remember that inflation alone would bring the $95k to ~$180k. and on the whole, what % of a hospital's budget is dedicated to malpractice insurance/risk management processes?)

All in all, I think in this kind of environment - I wonder if many hospitals "stay the same" for very long - they are either one their way up or down, and quickly.