The Slaughterhouse Mentality

In this crazy world of health care costs where those in CEO seats think health care should be run like the manufacturing industry, it’s rare to find someone who can see the emperor has no clothes.

In her blog post “A Robotic Hysterectomy is More Expensive, But is it Better?”  Dr. Jen Gunter reports on when the newest technological toy, robotic surgery, is beneficial with hysterectomy patients and when other options are equally useful, but much less expensive.

The assumption back when we wrote Modern Medicine: What You’re Dying to Know was that consumers demanded all this technology.  Back then it was laser surgery and MRIs. Yes, the technology changes, but the dynamics of what goes on does not. Its wasn’t the consumers demanding the technology. It was the hospital CEOs who wanted to see their horrendously expensive equipment used as much as possible. Dr. Gunter rightfully questions when the expensive toys are called for and when they are not.

Corporate health care organizations are going to be run like manufacturing businesses because that’s what CEOs are trained to do.  Salaries are big drains on corporate entities because they are not something that can be written off at tax time.  However, the cost of the new sign in the parking lot, or even the paving of the parking lot, can help reduce the appearance of income.

Corporate CEOs are trained to make the bottom line look good.  They are not trained to respect the needs of patients or those providing the care of those patients. They do not understand that providing appropriate patient care is their business. Indeed, they cannot provide appropriate patient care if they are going to keep the bottom line looking manufacturingly good.

Most of the numerous television series dealing with hospitals and clinics, whether it’s “ER,” “Gray’s Anatomy” or any of the many lookalikes, deal with what the cost-cutting administrative CEO does to the provision of quality health care.

Patients know this.  Health care practitioners know this. But for some reason, those regulating health care have been unable to see that the emperor has no clothes when it comes to corporate medicine driven by the wrong models.

Cost cutting at the expense of patient well being is the only mode of operation possible when it comes to the management of corporate health care entities by CEOs trained in manufacturing models. Temple Grandin worked years to get across to the managers of stock yards and meat packing plants that animals deserved to be treated with kindness and respect, and she tells this story in her first book, Thinking in Pictures.

The provision of health care is not a manufacturing business.  It isn’t even just a service business.  When it comes to the welfare of a community, the provision of health care is no less important than the provision of fire and police protection.

Until those managing the business of health care with the manufacturing mentality are replaced with those who understand that what patients need should be the underlying driver of what health care is provided, real health care will continue to go the way of the slaughterhouse.

dhaugen
Some young HR person once looked at my CV and asked me, quite seriously, if I had really done everything I had listed there. Well, yes. Because I am someone who can't sit in a Morris Miller cubicle every day, much less for any great stretch of time. Once the problem is solved, I get bored and I'm ready to move on to the next challenge. This hasn't afforded me any great stability in my work life. I simply arrive in places about ten years ahead of time. So far, at least, that penchant for early arrival hasn't been accompanied with a pocketbook full of door knobs.
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