Sunday, February 08, 2015

No One in Charge

In my professionally active days, I liked to tell young administrators that a hospital was an institution with nobody in charge and that success came to those who learned to be productive in that circumstance.

With all the changes that have been taking place in recent times, I came to think that perhaps that advice was out of date, but apparently not so.

Partners HealthCare, the Boston health care behemoth, has just appointed a new CEO, one Dr. David Torchiana.  Since 2003, Dr. Torchiana has been chief executive of the Massachusetts General Physicians Organization, consisting of some 2,000 physicians on the medical staff of the Massachusetts General Hospital.

The appointment was announced in a front page, above the fold article in the February 5 issue of The Boston Globe under the byline of Pryanka Dayal McCluskey and Robert Weisman.  Part way into the article, the reporters, referring to Dr. Torchiana, state that ”In the medical world, the doctor group he heads, consisting of some of the top doctors in the nation, is considered as influential as the hospital itself.”

So it seems that my old observation still applies at the Massachusetts General Hospital.  It is an arrangement that can be made to work as long as nobody cares about cost.  But that is no longer the case.  The Globe article also mentioned the recent denial of the Partners expansion plan by Suffolk Superior Court Judge Janet L. Sanders, who, according to the reporters, “was concerned that a bigger Partners would mean higher health care costs for consumers.  Partners is the state’s highest cost health system.”

The reporters did not connect the reference to influence with the cost issue, but Dr. Torchiana will have to.

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