Monday, June 22, 2015

Institutionalizing Medicine 

I think that the biggest challenge facing health care management today is the institutionalization of medicine – a profession that has historically defended itself vigorously against any loss of independence, a stand that has enjoyed general public support.  As evidence of that support, I frequently ask people whether they think their doctors should have bosses.  I have yet to get an unqualified “yes” as an answer. 

So it’s the brave healthcare executive who tries to incorporate the medical profession into a program for addressing the health care issues of the day. 

And yet there is little choice other than to try to do so.  Although they never say so in so many words, Obamacare, insurance companies, employers and other major health care players are adopting strategies and implementing programs that can only be responded to effectively by making the medical profession a part of the effort – in other words, by institutionalizing medicine. 

It is not easy.  The June issue of H&HN, the journal of the American Hospital Association, carries an article entitled The New Health Care CEO.  The article reports a survey on what health care CEO’s consider to be “the primary hurdle to achieving your organization’s strategic priorities”  The results are: 

Physician buy-in and engagement                            26%
Financial constraints                                                    15%
Organizational barriers to collaboration                  26%
Lack of talent or skill sets for key roles                     14%
Cultural impediments within the organization        14% 

I think it reasonable to suspect that every item listed, except for financial constraints, has to do with the institutionalization of medicine.





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