Hospital administration is a difficult job that requires the professional to oversee and manage all aspects of operations within the hospital setting. Administrators recruit, hire and train doctors, nurses, interns and assistant administrators. They also plan budgets, set rates for health services and marketing campaigns.
As part of “clinical excellence” administrators evaluate doctors and other healthcare professionals to help them develop procedures for medical treatments, in-house referral and overall profitability for the hospital. While doctors check your pulse, a hospital administrator checks the profitability pulse.
First Create Trust – Then Exploit Them
Hospital administrators directly manage and oversee the “performance” of their doctors. They do this by comparing a doctor to “standards of care” set forth by policy that they have created to make money. Administrators look at you as a number, a big dollar number. A patient visit to your doctor is a checklist for profitability set forth by the administrator. A specific diagnosis is profiled and the recommendation is based on profitability protocols.
Assistant administrators do their clinical rounds and discuss the performance of doctors based on statistics versus impact and efficiency. Based on averages set forth by policy; a patient will receive a set percentage of referrals to physical therapy, occupational therapy, nutritional counseling, laboratory work, advanced imagining and specialist referrals. Before you step foot into the patient exam room a profitability schematic and flow chart is established that a doctor knows he/she will be evaluated by the administrator on their next performance review.
Have you been in a restaurant and the server is trying to upsell you? Would you like to start with an appetizer? Would you like to finish with dessert or coffee? It is the same in the hospital. It sounds like you are depressed? Do you have trouble sleeping? Do you have trouble concentrating? Every year you should have your prostate checked. You are overdue for your yearly mammogram. Condition suggestion is not only present in pharmaceutical sales, but also in your doctor’s office.
The Secret Underground of Medical Errors
The Agency for Healthcare Research and Quality released data that shows that most physicians, nurses, pharmacists and other health professionals that are working in a hospital to believe their organization is more interested in punishing slight missteps and enforcing institution hierarchy than preventing and reporting “adverse-events”.
The agency’s findings expose the underlying tragedies that result in thousands of preventable hospital deaths every month and other untold catastrophic harm to other patients. When healthcare becomes a profit flow chart, people die. The death and lifetime damage caused by healthcare upselling needs to be overhauled. The clinical and administrative leaders need to set different standards of care.
To see the application of philosophy and corruption one can look at an event that happened at Beth Israel Deaconess Medical Center in July of 2008. As a patient woke she asked, “Why is the bandage on my right ankle instead of my left?” Immediately the surgeon realized that he had operated on the wrong ankle. Punishment in this situation was more likely to contribute to a hospital culture of hiding errors rather than admitting them. And it was only by nurturing a culture in which people freely disclose errors that the hospital as a whole can focus on eliminating medical errors.
Let’s Put a McDonalds on Campus
It is against policy, a direct conflict of financial interest and considered unethical for any healthcare professional to recommend healthcare services outside of what is considered “standards of practice” within one’s hospital system. This is one of the primary reasons chiropractic is not further accepted within healthcare.
It’s communication for health advocacy is against profitability models and does not provide a sufficient mode of in-house referral and income generation inter-professionally. Chiropractic does not encourage routine “preventative” screening procedures that administrators use as marketing campaigns to capture life-time, income producing patients.
There is a fight for who provides perceived healthcare to a nation of sick, overweight and over medicated patients. The fundamental difference is one sector provides and encourages a sick care model versus a healthcare model. The healthcare model of prevention and maintenance of health empowers a patient to take self-initiative that will reduce the reliance and participation in the profit making, sick care model.
My objective today is to confess. It is my responsibility to establish a culture of safety. I had unknowingly and inadvertently relinquished my responsibility by exclusively focusing on the traditional duties of management, planning and finances. Until management learns to “own” these errors instead of blaming others and sacrificing patient care for profits, nothing will change.