The nation may be split on whether Congress should pass the $700 billion bailout plan for the financial industry. But one thing that people—both Republicans and Democrats—seemed to agree on this week was that legislators displayed a profound lack of leadership.
Legislators have been criticized by both advocates and opponents of the rescue plan as being more concerned about people's opinion and getting reelected than doing what is in the best financial interest of the nation.
The public view is that leaders need to be able to make tough decisions regardless of public sentiment—and healthcare is no exception. If the reimbursement climate and financial crisis is any indicator, hospital CEOs will be forced to make even more difficult choices in the years ahead—many of which will be unpopular with members of the community, employees, and clinicians.
Hospital leaders cannot be reactive, either, according to the hospital CEOs I have spoken with recently. They must be able to quickly assess the situation, make a decision, and follow through on the plan. Healthcare executives also need to be creative, because old solutions, operating models, and business practices will not solve new problems.
I heard a CEO at a conference recently say that being a leader can be "lonely and uncomfortable." For instance, no executive wants to lay off employees. But if headlines are any indication, we'll see many hospitals doing just that. Some of these layoffs are not the result of poor financial health of an organization, either. A healthcare system may simply want to restructure and centralize its organization as a way to improve efficiency. Still, layoffs will put people out of work and the remaining staff will be sad to see colleagues leave, and let's face it, maybe a little bitter about some of the cuts that were made.
Recently, I spoke with Jim Sanger, CEO for SSM Healthcare-St. Louis Network, about the organization's decision to cut roughly 120 positions. His advice is that organizations need to ask themselves, "If we make these changes, will we be a better organization when it is over." If the answer is yes, then it is the right decision. That doesn't lessen the turmoil or make the process any easier, Sanger adds.
Similarly, people don't want their hospital to abandon a service line. But hospitals can no longer be all things to all people. Healthcare executives will need to carefully evaluate what services their hospital can and should provide. For some hospitals that may mean cutting the OB/GYN department, long-term care unit, rehabilitation units, or community outreach programs.
When tasked with making these types of controversial decisions, hospital CEOs need to ensure that the choice is clearly explained to employees and community stakeholders. Explain why this plan is in the best interest of the organization. They may not agree, but communicating your message may be the best tool to keep the trust of your employees and community at large.
Carrie Vaughan is leadership editor with HealthLeaders magazine. She can be reached at cvaughan@healthleadersmedia.com.
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Westlake, OH-based St. John West Shore Hospital has laid off 22 staff members, citing the overall changes in the hospital business and a desire to increase efficiency. The cuts at the 248-bed hospital were made in full and part-time positions, and include management, clinical, and non-clinical staff, according to a statement by the hospital.
Critical Health Systems of Raleigh, NC, has been purchased by a division of Sunrise, FL-based Pediatrix Medical Group for an undisclosed amount of cash. Critical Health is currently the only provider of anesthesia for hospital patients in Wake County, NC. The company has long-term contracts with medical facilities in North Carolina, but officials at WakeMed and Rex Healthcare said they don't expect to see any changes after the sale.
Doctors aren't going into primary care anymore, despite a rapidly aging population, according to an article in the September 2008 Journal of the American Medical Association. The resulting problem is that even if healthcare coverage becomes universal, there will not be enough primary care physicians to go around, according to this opinion article in the Denver Post.
Kaiser Permanente has found an innovative solution to its shortage of dermatologists: the roving physician. The program involves arming a dermatologist at each Kaiser site in the Diablo, CA, service area with a cellular telephone to respond to the call of primary care doctors with patients that display suspect moles or non-obvious skin rashes. The roving dermatologists can provide same-day assessments and biopsies of skin lesions, saving patients the month-long wait it can otherwise take to get an appointment with a dermatologist.
In this article, BusinessWeek asks whether or not doctors are hypocrites as part of a debate over whether doctors are "glorified merchants" or benevolent professionals deserving greater respect. One side argues that today's doctors put their pocketbooks first and patients second. The other points to the years of training and long hours doctors put in to make the case that medicine is still an art and doctors are underappreciated.