“Take care of your people and they will take care of your customers.” – JW Marriott
Every busines offers a product. Offering the best version of that product is the main aim of any business..
A hospital is no different. It offers a product. It’s called “Patient Care”
Every hospital aims to offer the best patient care versus all the other hospital competing with it for business.
The most immediate face of patient care in any hospital aren’t the doctors, administrators or janitors. They are the nurses. They are the most immediate parameter used by patients to rate care in any hospital. The care they give will make or break a hospital.
So a hospital that aims to win business and be seen as great cannot afford to skimp on nurses. That hospital will aim to get the best and most experienced nurses. They will also get younger nurses who hopefully can take the place of the older nurses one day but they will not be the dominating group in the nursing pool. The older and more experienced nurses should be.
Then you come to the doctors. You want the best. If you have good ones, you strive to keep them. If they threaten to leave, you try to meet them halfway. If they are surgeons, you stroke their ego – you may need both hands! Then remember the product you offer is patient care and you need good nurses and doctors to achieve that.
Interestingly, there is a trend in the US that boggles the mind. Hospital administrators seem to have forgotten what the product is. They’ve forgotten what really matters. They are bogged down by the numbers so much that they have lost sight of what their product is – Patient Care!
So some lay off nurses, get rid of good doctors, seeing personnel cost as a liability instead of an asset and in the process, worsen patient care. They nickel-and-dime the quality of their product to death – no pun intended.Personnel costs may be a problem when one is dealing with the Post Office but in a hospital, that is the key for a great product.
Now this happens because a lot of hospital administrators honestly do not know and understand the ins-and outs of patient care. Running a hospital is not the same as running, say, UPS or Walmart. They are both businesses but one deals with people – sick people – and there is a high degree of unpredictability that the numbers do not always reflect. That is the problem classically-trained business minds have. It is no accident that physician-owned-and-ran hospitals do better than non-physician-owned ones. It is also interesting that the longer an administrator has been at a position in a hospital, they better the decision-making gets. This is because they are forced to develop relationships with the doctors and nurses and thus acquire a feel for that unpredictability.
Which brings me to my point – that hospitals should be run by physicians and nurses, supported by a finance team. This should be a physician who does clinical work not a desk-hugger. It is the only way that the product, patient care, will always come first and not some arcane numbers. Having a finance team will reduce any excesses that physicians are sometimes prone to when new medical technology or drugs are available. The vision of a hospital will also be more in line with the real needs of patients in a community and the future of medicine not the numbers. The other doctors and nurses in the hospital are more apt to find a listening ear in a physician CEO than a classic MBA daydreaming about numbers and spreadsheets.
Sure, not every physician can be a good administrator but honestly, looking at what is out there now and how physicians and nurses see being treated all over, what do we have to lose?