Climbing the Corporate Medical Ladder

Everyone in medicine has the well-being of patients as their highest priority, right?

In her climb up the corporate ladder a woman had become the new administrator in charge of the physical therapy unit. Like nearly everyone in management, she was not done climbing. The hospital was trying to rein in costs. Labor was a particular focus. Upper management’s agenda was to make it a smaller percentage of expenditures in each department.

She figured out that the way to work that formula was, in part, by spending more on supplies. She shifted money normally spent on labor to supplies. Just cutting labor did not make the percentage come out as well as simultaeously increasing spending on supplies, which could be arranged without increasing the budget by taking the money away from labor. The department became jammed with so many supplies that there would be no need to order more for several years. But she did not expect to be around for that.

What is the definition of bureaucratic inanity?

The man in charge of the physical therapists had been pointing out that the physical therapists were not getting enough hours to care properly for the patients. Medicine doesn't not track its effect on the well-being of patientsPatients sat waiting for busy therapists to pay scant moments of attention to them during their visits. He felt the patients were suffering for this.

She talked about taking care of the budget. He said he thought they were supposed to be taking care of the patients. Because she had made it impossible for him to take care of patients the way he believed he should, eventually he quit. She got promoted, probably in part because of how good she was at eliminating employees who didn’t play ball her way. She moved to a higher position where she could bring her management style to bear on an even larger segment of the hospital.

It is not certain that administrators with medical training would make better decisions. Such administrator have a history of not even protecting patients from serial killers. That side, it is the frontline workers in medicine who do not report 93% of the problems that occur in medince (see medical reporting). How can any administrator make patient-friendly decisions when no one tells them what is going wrong?

If you want some numbers about management without hospital backgrounds, there are some in this article in Healthcare Finance News (links to another site).

Back Flip

What about when a patient is harmed and there is a mechanical way to keep it from happening again? How does management in medicine respond to that compared to how auto manufacturers respond to problems that could harm their customers? Click here for an account of that.