Medical: The Business Of Health

Hospitals today have mostly moved away from the staff run facilities they once were and redefined themselves as businesses.  Hospitals are there to make money.  It is a business and its run as such meaning protecting the bottom line at all costs.  There is something to be said for this.  As a business they have to run at optimal efficiency to provide a service at an acceptable cost to the end user...that will be us mere mortals. 

On the other hand, redefining needs reclassification so Hospitals become businesses and patients become clients.  They design the buildings with aesthetic appeal and psychological influence that will attract new investors.  These decisions don’t really affect us in any major way but sometimes they try to apply a “paint by the numbers” strategy and this is where problems come to light

For example a fast food restaurant such as McDonalds builds their stores out of selected predesigned schematics without really taking into account whether certain features are redundant in the new store location.  Probably why no one is ever manning window 2. 

It’s the age old mix-up between form and function.  A hospital that has plenty of space but scarce recourses and inadequate staff is worse than useless. They can’t treat an influx of patients and those patients that they already have has to be content with subpar care and service.  The next problem comes when scholars are promoted over those with practical experience on the floor.  This happens because all the qualifications that a scholar stacks up looks good on paper and so naturally having a person in charge with a good rapport card gives a feeling of trust and security.  Unfortunately most if any have little experience in the day to day factual requirements of what it takes to run the facility. 

They are required to make decisions affecting the lives of staff and patients alike and usually come up short.  I’m very much in favor of scholarly achievement and of clinical experience, both have their uses and they do it well but they shouldn’t try and work independent of one another.  We need a fusion process where the person in charge aka “the man” has both of these qualities. 

Theory is all well and good but practical application is equally if not more important than what the text books say.  A person who knows everything there is to know in the appropriate texts doesn’t necessarily make for a good manager.  A manager needs to be open to new ideas, be decisive, patient, focused, personable and disarming.  These are some of the qualities that makes a good leader.  What we get however is middle management.  Those who couldn’t care less what happens as long as their paycheck arrives swiftly. 

You know the old saying that doctors make difficult patients.  That’s because they always try and take over their own treatment.  This can also be the case when a doctor is put in charge of a hospital.  They tend to make decisions from the viewpoint of a physician.  I’m not saying this is always the case but it does happen.  So now you have a scholar who has practical experience about the difficulties that can arise on the job but still doesn’t perform well enough in the position of manager.  Not everyone is suited for the task of running a hospital and if the person in charge is negligent or inadequate then the whole health system of the hospital will suffer for it.

When you are in a business dominant system people that don’t occupy the very top of the spectrum where the decisions are being made have no influence in changing a system for the better.  The “If it ain't broke don’t fix it” attitude is ‘n lazy and incredibly stupid way to think of things.

 If everybody’s views were that simplistic we’d still be in the dark ages using sun dials and claiming anything that we couldn’t understand through the most basic of empirical observation was magic.  Magic is a nice enough word don’t get me wrong but it describes everything and nothing at the same time.  And that is the end results of these administrative changes in hospitals.  You get everything you want as long as it doesn’t cost anything.  You can change what you like as long as it doesn’t affect anything and you can use any resources you need as long as you have a realistic basis for your needs (upper management talk for go screw yourself) and filled in the appropriate forms in triplicate.

So the idea of Fusion seems the way to go.  Taking the best elements of both and combining them into one functional model.  But to do this you’ll need a leader with suitable qualifications (as outlined previously) who has knowledge of texts, law, risk management and above utilizing all the information he has in order to protect and champion the rights of patients and staff alike.  That includes the right to proper treatment by capable staff using modern medicine and cutting edge techniques.

I am reminded of a story where in the mental ward patients treatment were decided behind closed doors by people who had never seen the patient or interacted with them.  And the thing is the patient had their own ideas on how their treatment was going but lacked the confidence to express these feelings and ideas to a group of strangers.  So instead a young nurse took an interest in one of the patient’s case and started to listen.  When the tale was done the nurse wrote down all of the objectives that needed to be addressed and walked into the next meeting as a voice for the patient. 

Two weeks later amazing improvements were noted from what was once considered a hopeless case.  The patient eventually went on to live a mentally happy life and it was partly due to just one person breaking away from the status quo and finding a new way to do things for the sake of bettering the system, the staff and patients.