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...

gapingvoid cartoon #378

Buy your own, here.

"An Affordable Fix For Modernizing Medical Records"

...from the Veterans Health Administration and Midland (TX) Memorial Hospital. I know enough about my own strengths and weaknesses to know that I'm no IT expert. But I am acutely interested in examples of people and teams thinking differently to solve long-standing, intractable problems and, for better or worse, there are lots of those to be found in the IT realm. Yesterday, it was a story about a team adding iPhone portability to MEDITECH functionality, delivering to harried physicians better access to clinical data and more productive hours in every work day. (Wow. Apple in the boardroom AND the physician lounge. Has to be an IT traditionalist's worst nightmare. But I digress...) Today, the Wall Street Journal features a story about Midland (TX) Memorial Hospital finding an affordable, open-source alternative to proprietary EMR systems : "In the push to digitize America's hospitals, Midland Memorial faced an all-too-common dilemma: a crying need for information ...