Specialty hospital rise could add to full-service hospital woes.

Physicians may refer patients to specialty facilities in which they have an ownership interest, and they have no qualms about doing so. Specialty hospitals typically concentrate on delivering the highest-paying procedures and elective surgeries to the healthiest and best-insured patients. Most physician-owned specialty hospitals perform exceptionally well financially. Where specialty hospitals have proliferated, full-service hospitals have been damaged financially; one had its bond ratings reduced, and several have been forced to reduce or cut financially marginal services. In at least two communities, specialty hospitals appear to be associated with reduced access to trauma care.