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Brace for Healthcare Management Shakeups

Philip Betbeze, for HealthLeaders Media, June 3, 2011

That once might have been the case. But in many of the organizations with whom I chatted for my story, much of the reorganization results in placing physicians in positions of responsibility and power in the organization, where once they might have had big voices but little accountability on the business rationale for what they were arguing for.

No one understands the importance of data better than a physician, so it's a little ironic that hospitals were pushing physicians to follow evidence-based treatment guidelines and protocols while eschewing that philosophy in the purchase of drugs, equipment, technology, labor and other myriad expensive things any healthcare facility must purchase.

For instance, today's CMO is much more than a guy who's popular with all his physician friends. Instead, he or she is a voracious consumer of evidence. That's not just on treatment guidelines, it's also in determining where to put the latest imaging machine or whether it makes sense to buy it. In the past, equipment might have gone to a hospital that was conveniently located near a high-volume physician who would be using it, regardless of the market's need for it, or the ability of system-wide scheduling to avoid unnecessary delays.

Many hospital systems in the past have been systems in name only. Essentially there's a small core group of professionals at corporate headquarters, but individual executives at the local level made virtually all decisions regarding their facilities independently. That model appears to be going the way of the dinosaur. In any case, it's time to start thinking about how your system is going to change to meet the new realities, which are lower reimbursement and higher accountability.

Are you looking for ways to meet that challenge with new voices, new organizational structures and new protocols? If not, you should be. The leaders are.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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3 comments on "Brace for Healthcare Management Shakeups"


John (6/8/2011 at 4:32 PM)
Robert, it's interesting that the airlines analogy was used. We know how well that's worked for them...

Robert Trinka (6/7/2011 at 11:43 AM)
Phil, it is interesting that Thomson Reuters recently ranked the Top Ten Health Systems, which includes names like Advocate Health Care, Mayo, Partners Healthcare, etc. The eight criteria they used included, In-hospital mortality, Medical complications, Patient safety, Average LOS, 30-day Mortality rate, 30-day readmission rate, Adherence to clinical standards of care, and "HHS" patient survey score. No specific inclusion of expense management, cost controls and containment, or per cent increase/decrease in total cost of care. Ironically, the single largest issue facing all healthcare providers (whether they know it or not) is COST! A hospital or health system management team should be looking at major real cost reductions over the next 5 to 10 years of up to 50%, while improving quality standards and benchmarks. Impossible? No. And if no one believes that will be required, just ask the airlines (post 1978 deregulation) and other industries that have had to change the way they did business to dramatically reduce cost in a short period of time while maintaining the essential standards of service and performance. That will be the challenge and the survivors will figure out how to do it.

Stefani (6/6/2011 at 2:18 PM)
Phil - The hospital infrastructure is archaic. We all know that. A dual governance system is just plain inefficient and perpetuates the 'we-they' dichotomy that keeps the medical staff distant from the executive staff. Each must share the same economic and quality goals and have equal interest in achieving them.