Why the Hospital’s Idea of Physician Leader Means Follower

January 19, 2015

It was the time that I almost died. The car was out of control and I was headed for a cliff.

Then I awoke from the dream in a sweat. The smell of pancakes wafted in from the kitchen.

I recently read an article about hospitals training physicians for “leadership” roles.

What those hospitals are really doing is training more physicians to become hospital-employed or hospital-controlled managers in order to monitor, cajole and threaten the members of the medical staff to follow mandated cost cutting measures. Oh, excuse me, they called them “quality goals.”

Don’t get me wrong, I’m all in favor of better quality. I am in favor of doing things the right way. But who should decide what the right way is for Ms. Betty Bobson, age 47, or Mr. Bob Beatty, age 74, the hospital or that patient’s physician?

I’ve dealt with instances in which a surgeon’s orders were changed, without consultation, by a hospitalist engaged by the hospital. When the surgeon complained, she found herself subject to a medical staff investigation. Oops! Just a coincidence!

So, if you’re the hospital CEO, why not put that situation on steroids?

Instead of the sole hospitalist changing orders, the hospital can now instruct all of its employed or controlled physician “leaders” to enforce what the hospital deems to be evidence-based best practices or protocols or whatever the name of the week is for cookie cutter behavior or for using only those products or pharmaceuticals on which the hospital gets the best deal. But the bottom line is the same: Who is making the decision, Ms. Betty Bobson’s physician or the system?

Don’t get me wrong, I’m all in favor of physician leaders. In fact, I wonder if an all physician board and all physician top leadership should be requirements for a hospital’s Medicare participation? Think about that for a while.

But in the politically correct patois of Orwellian hospital double-speak, “leader” now means follower.

Is following orders best for patient care? Is it really best for your career?

Your career is in a car and it’s heading over a cliff. Ms. Betty Bobson or Mr. Bob Beatty is in the passenger seat. No, it’s not a dream. No one is in the kitchen making pancakes. Grab the wheel and do something before its too late.

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