Wednesday, October 16, 2013
Culture Change
I find culture change a fascinating thing to watch.
When my career began some sixty years ago, one of the
unwritten but cardinal rules was that hospital administrators did not interfere
in clinical matters. Those were the
province of the medical staff.
Although the subject has been too sensitive to address
directly, the situation has gradually been changing.
A short Associated Press article in the October 15 issue of
The Boston Globe deals with it, albeit indirectly. The federal Centers for Medicare and Medicaid
recently reported that while chief executives at nonprofit hospitals earned an
average of $600,000 a year in 2009, and some earned as much as $3,000,000,
there was no relationship between earnings and 30-day outcomes for patients
with heart attacks, heart failure or pneumonia in 2008.
Dr. Ashish Jha, a health policy professor at the Harvard
School of Public health was quoted as saying that these results were “a little
disappointing” and that to not hold chief executives accountable for whether
patients live or die within 30 days of treatment “doesn't quite make sense.”
Dr. Jha doesn’t seem to realize that it is still possible
for hospital chief executives to get fired for meddling in things like
that. The Associated Press apparently
doesn't either.
But the bland, matter-of-fact tone of the report suggests
that the day may be in sight when executives could get fired for not
doing so.
My, my.
