Wednesday, June 8, 2011

Physicians Take Back Your Hospital !

 

Physicians, Take back your Hospitals !

I was listening to Piers Morgan interviewing Jack Welch, former head of General Electric. Jack Welch led General Electric from a $30 billion dollar company to one worth over $130 billion dollars. Watching the interview one thinks, how could he not succeed ?

“An organization's ability to learn, and translate that learning into action rapidly, is the ultimate competitive advantage.”

“Change before you have to. Control your own destiny or someone else will. Face reality as it is, not as it was or as you wish it to be.”
“The Internet is the Viagra of big business”
(Jack Welch’s quotes)

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In listening to Jack Welch speak one realized he has the remnants of a slight stutter, a challenge he overcame in due time. One thing for sure, he never stuttered in his vision for General Electric.

Jack’s enthusiasm overflows onto his audience. I was moved by it and wondered how this enthusiasm could be transferred to you and me as physicians.

Jack talks about integrity, something which has eroded in our medical ethics and perhaps the foundation of what our patients admire most in physicians. Patients still trust physicians to accomplish what is most important for them when they come to us in hospitals, clinics and the operating rooms of our hospitals…

What has happened is that too many of us, not out of greed, but necessity have allowed bureaucrats, government and foolish regulations to control our patient’s destinies, and thereby us as doctors. Most physicians are now bogged down with financial survival, having business that must be sustainable. This is true whether we are in private solo practice or a large multi specialty practice. Some think that a large practice insulates them from financial ruin or disaster. This is just not true, although it appears this way in the present phase of growth of overwhelming regulation and intrusion of government bureaucrats and insurance companies..

Creativity is maximized by ‘protected time’ a commodity rare in clinical practice.

Bureaucrats are convinced they know more about outcomes, evidence based medicine, cost containment, telling physicians to practice medicine and let them run the business. During my career I have seen this lead to many disasters.

Today many of our brightest innovators and bright minds are choosing technology industries to make a living. I write a column on technology, and it is apparent the energy is there. Young and old entrepreneurs are dynamic, innovative, daring and have a goal in mind. Our young physicians are turned out, and quickly become burned out, too busy and overwhelmed to energize their own creativity.

Some of our brightest minds go into medicine, only to become disillusioned at the prospect of preferred practice patterns, regimented paradigms to ‘improve outcomes’ when there is little scientific evidence that it works. The results thus far are disappointing, and not tested by time.

I agree that systems are critical to hospital efficiency and safety. Within reason some hospital activities would benefit from business techniques such as sigma six.

How many physician executives demonstrate the enthusiasm exhibited by a Jack Welch or a Donald Trump? Most clinicians are senior when they become executives or management leaders. True creativity for most occurs in late teenage years, and early adulthood. There are some rare older leaders in medicine, however they usually demonstrate this skill at a younger age and are promoted to leadership by staff members as a result of their demonstrated exceptional clinical skills. It is a rare physician that excels in clinical acumen and leadership qualities making for a competent departmental leader. Academic medicine has the distinct advantage of structure and close peer review leading to the correct selection of physician leadership. This is not true in private practice where individualism outweighs collaboration and team spirit.

The paradoxical thing is that most physicians are highly social, and must relate to people of all walks of life, financial means, social setting, and have a better understanding of human nature. It is just not applied other than in a one on one setting, physician to patient and vice-versa.

Jack says, “ Act Quickly”. We must, its almost too late. !

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