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Wednesday, January 03, 2007

A Handicap to Overcome

Last summer two prominent hospital CEO’s in Chicago announced their retirements. One was Dr. Anthony Barbato of Loyola University Health System and the other Gary Mecklenberg of Northwestern Memorial Health Care. I do not know Barbato. Mecklenberg is a fellow alumnus whom I have known for many years and who in my judgment may well be the outstanding health care executive of his time.

Interviews with the two of them were published in the September, 2006 issue of Hospitals and Health Networks, which is the journal of the American Hospital Association.

If someone were to ask me what was the most significant change in hospital management that had occurred during my lifetime, I would without hesitation have said that it was the steady increase in the hospital’s responsibility for managing physicians and the way they practice medicine. Several articles in that same journal dealt with that topic indirectly. But neither Barbato nor Mecklenberg made direct mention of it.

I take that to be an indication of the unusual situation in which we find ourselves – which is that a subject central to the issue of health care reform and redesign remains so culturally sensitive that it can’t be discussed publicly.

Midway in the interview report Mecklenberg is quoted as saying “I suspect that Tony and I have done something right or we wouldn’t have the tenure we have.” Apparently one of the things they did right was to manage medical practice effectively without either mentioning it or being caught at it.

Unfortunately, most health care managers are not as capable as Barbato and Mecklenberg and so this “don’t ask don’t tell” approach to the management of medical practice is a handicap that needs to be overcome.

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