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.

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