The Business of Healthcare

Avoid Bureaucratic Bloat

March 6, 2023

In just one week of driving, I passed a Dallas police car, Dallas school police car, a Dallas transit police car, a Dallas sheriff’s car, and a Dallas constable’s car.

Why so many police departments? I would assume each one has a police chief/equivalent, a bunch of assistants, and dozens-to-hundreds of bureaucrats sitting behind desks. Why?

Instead of waxing political, let’s just take that tripling or quadrupling of bureaucracy and look at a normal healthcare facility, a hospital, for instance.

How many levels of bureaucrats (called administrators) are there? Are they all needed?

Now I know that my audience doesn’t, for the most part, consist of people who work for hospitals, as opposed to at hospitals. But it consists of many who own large medical practices, healthcare facilities, surgery centers, imaging facilities, and other sorts of healthcare business entities.

Do you need that same level of bureaucracy?

Unfortunately, many large medical practices and other healthcare businesses have transplanted hospital-level bureaucracy into their operations.

Maybe they think that level of bureaucracy is necessary based on the owners’ hospital experience.

Or maybe their business’s administrator, call him or her a CEO, COO, or whatever, duplicated hospital-style bureaucratic bloat because, well, that’s the way it’s done.

Or, maybe it’s because you have a hospital partner that manages your practice or facility. Perhaps it’s applying the same “best practices” that result in managing most hospitals into unprofitability.

Do you want to operate your practice or other healthcare business like a county with least 5 separate independent departments all doing the same job, or, sometimes, no job at all?

Who do you have doing what, and why? How could bureaucrats be terminated with no impact upon your business’s function? What could be outsourced for less?



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