Skip to main content

Docs (Or Maybe Nurses) In Charge

Bob Lutz attributes the auto industry's decline to the pervasive influence of 'bean counters' - MBAs who know the price of everything and the value of nothing.  From a review of his new book "Car Guys vs. Bean Counters:"
"The only time Apple ever lost the plot was when it put the M.B.A.s in charge. As long as college dropout Steve Jobs is in the driver's seat, customers (and shareholders) are happy. The reason is clearly the one Lutz puts forward in his book: 'Shoemakers should be run by shoe guys, and software firms by software guys.'"
And car companies by car guys and, dare we say, hospitals by health care guys and gals.  But which health care guys and gals, exactly?  We may know the answer to that thanks to Amanda Goodall PhD, a senior researcher at the Institute for the Study of Labor (IZA) in Bonn, Germany, and author of a study of top-performing health care organizations.

Goodall's research finds that top-performers are more likely to be led by a physician, not a 'professional' manager:
"...outstanding hospitals tend to be those run by somebody with a medical degree. I was surprised by the strength of the pattern. It seems that age-old conventions about having doctors in charge - currently an idea that is out of favor around the world - may turn out to have been right all along."
Can you name a truly great health care brand that's NOT physician-led?  Maybe a few, but not many. 

Car Guy Lutz doesn't write about health care, more's the pity, and no rules are universal.  I've known many wonderful, caring M.B.A.s and some breathtakingly stupid physicians.  But health care needs a few arrogant cranks like Lutz calling 'time out' on the bean counters.  Maybe I'll volunteer.

And were it up to me, I'd put the nurses in charge.

More:

Time: Driven Off the Road By M.B.A.s

Medical News Today: Physician Leadership In the Best Hospitals

Comments

Popular posts from this blog

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor

Being Disrupted Ain't Fun. Deal With It.

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcare

My Take On Anthem-Cigna, Big Dumb Companies and the Executives Who Run Them

After last Friday's Appeals Court decision, Anthem's hostile takeover of, er, merger with Cigna has but a faint pulse. Good. Unplug the respirator. Cigna's figured it out but Anthem is like that late-late horror show where the corpse refuses to die. Meanwhile, 150 McKinsey consultants are on standby for post-merger "integration" support. I guess "no deal, no paycheck..." is powerfully motivating to keep the patient alive a while longer. In court, Anthem argued that assembling a $54 billion behemoth is a necessary precondition to sparking all manner of wondrous innovations and delivering $2.4 billion in efficiencies. The basic argument appears to be "We need to double in size to grow a brain. And just imagine all those savings translating directly into lower premiums for employers and consumers."  Stop. Read that paragraph again. Ignore the dubious "lower premiums" argument and focus on the deal's savings. $2.4 billion saved