Wednesday, October 25, 2006

Practice before Principle

Early in my career I learned that people are often willing to do in practice what they would never agree to in principle.

I thought of that when I noticed an insert in last Sunday’s New York Times (October 22, 2006) titled National Hospital Guide. It was a special advertising section “designed to help you better manage your health care needs.” It listed, briefly described, and gave contact information for 34 leading hospitals. The group included the “usual suspects,” from the Massachusetts General Hospital in Boston to the University of California at San Francisco Medical Center.

I don’t know how much it cost each hospital to get included – I suspect quite a lot – but that is not what captured my attention.

What I noted was the implicit assumption that the way to seek the best medical care was by picking the right hospital. The six individuals featured were not star-quality physicians. Four were non-M.D. CEOs, one an M.D. CEO, and one an M.D. physician-in-chief.

In principle, we want to think that seeking good care means finding the right doctor. But in practice that is ever so gradually changing – as it must - to relying on hospitals, as shown by the NYT insert.

The next step is for CEOs and Trustees to accept the responsibility they are being given.

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