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Health System Ethics Made Simple

John Commins, for HealthLeaders Media, January 13, 2011
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Over the generations, hospitals and health systems across the nation have created and passed on homegrown cultures of conduct, trust, and accountability that rely on long-term personal relationships, an understanding of their vital healing mission, and a sense of commitment to the communities they serve.

Healthcare delivery is changing rapidly, of course, and the tradition of building a culture of ethics one relationship at a time could be overwhelmed. Healthcare consolidations are a weekly event. Hospitals merge, or they are swallowed by larger health systems that sometimes merge into super-systems serving several states. The sense of community that existed in a small hospital can experience growing pains and an identity crisis when the newly merged physicians, staff, and executives find themselves among thousands of employees in a larger health system.

"We are dealing with that right now," says Andrejs Avots-Avotins, MD, PhD, a gastroenterologist and chairman of the board of directors at Scott & White Healthcare in Temple, TX. "When I came here 21 years ago we had 350 physicians and it was pretty easy to get to know most of them. Today we have closer to 900 physicians, a total of about 1,200 healthcare providers, and12,000 employees at 60 different sites spread out over 25,000 square miles. It's not so easy to do."

Even though Scott & White has built a strong culture since its founding by two physicians in 1897, "how do you communicate that to all 12,000 employees---particularly when half of our employees, including half the docs, have been with us for less than five years? This is a challenge for us as well," Avots-Avotins says.

In the face of dynamic growth, Avots-Avotins says Scott & White leadership continues to focus on what it knows best: patient-centered, physician-led healthcare.

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