Collaborative Systems

March 15th, 2009 by Kenneth Cohn

A friend who is a retired COO of a Western hospital sent me the following e-mail after reading my column, A Practicing Surgeon Dissects Issues in Physician-Hospital Relations:

You are to blame for getting me to think as a hospital administrator once again- since I have really been enjoying semi-retirement!
You mention the implications of the relationship that occurs between healthcare leaders and their boards. In today’s hospital setting, many hospitals are part of systems, and the CEOs report to someone at the corporate level. It might be interesting to include some reference to this dynamic and its implications in future writings:
Physicians who are part of a system may see their hospital CEO as having little authority to solve medical staff issues:
     -Physicians may find it challenging to work with system CEOs, authority figures whom they seldom see and may not respect;
     -Hospital CEOs are unable to impact system policy [i.e. finance, IT] quickly- one might speculate that it’s  easier for the CEO of an independent hospital to impact change and be more physician responsive through a local board;
     -Risk-averse hospital systems tend to make medical staff decisions heavily weighted toward avoiding risk, as opposed to balancing risk vs benefit. The legal department of a healthcare system influences decision-making more than the local CEO.
Thanks again for stimulating the brain cells!

What do you think?

Do hospital leaders whose hospitals are part of larger systems have local control
How does working within a healthcare system impact physician workflow
What are the implications for patient care

As always, I welcome your input to improve healthcare collaboration.

Kenneth H. Cohn

Posted in Learning