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China Calling

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An exchange program helps a New Jersey hospital executive offer leadership insight on the other side of the globe.

John F. Bonamo, MD, has done his share of traveling to see how other healthcare leaders manage their hospitals. But earlier this year, a physician leader exchange program helped the executive director of Saint Barnabas Medical Center in Livingston, NJ, gain some fresh insights from an unlikely place 6,700 miles from home: China.

Bonamo spent five days in Beijing teaching hospital CEOs and managers there how to be more effective leaders. The majority of Chinese healthcare leaders are "first and foremost practicing physicians" with little leadership, finance, or business experience, Bonamo says. Such experience is becoming increasingly valuable as the leadership roles at Chinese hospitals, once government-run, are being turned over to the facilities themselves. "They're realizing that they need a lot more education about leadership to run a hospital," Bonamo says.

While there, Bonamo met with approximately 75 of his Chinese counterparts to explain aspects of the U.S. healthcare system, including the various quality measures taken in American hospitals, the Centers for Medicare & Medicaid Services, and the pay-for-performance model. "We talked about all of the things we now know about how to help drive quality in healthcare," he says.

The Chinese physician leaders were also interested in how the U.S. healthcare system as a whole operates—how things work at the hospital level and at the individual department levels. According to Bonamo, many hospitals in China are now moving to adopt hospital systems or health systems similar to those already established throughout the United States. "They're just now developing systems there, and bringing individual hospitals together," he says.

Additionally, Bonamo talked with the Chinese physician leaders about the importance of transparency. Currently, he notes, financial and other information is not publicly available in China—"everything is hidden," and many do not yet trust the idea of transparency. Bonamo says his talks helped him develop a greater appreciation for transparency's role in creating a more efficient system in the United States. "The curtain has been pulled back here," he says, adding that Chinese healthcare leaders must come to realize that "transparency is not evil" in order to successfully move forward.

A number of Chinese physician leaders are scheduled to visit 625-staffed-bed Saint Barnabas in November as part of a tour of several healthcare facilities to give them a firsthand look at the daily operations of a U.S. hospital and how different departments in a facility work together. Among the areas Bonamo plans to focus on will be how to work with practice employees, physicians, and fellow leaders to alleviate problems and complicated processes; the system currently in use in China, Bonamo says, involves determining who is at fault and subsequently firing them.

Despite the stark cultural differences in the U.S. and Chinese healthcare systems, Bonamo says his trip highlighted the similarities of the problems faced in both countries. "Regardless of language or culture, healthcare problems are universal."

Justine Murphy

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