Doctors vs. administrators: Can they get along?

Doctors vs. administrators: Can they get along?

July 2017

Published in the July 2017 issue of Today’s Hospitalist

WHAT KIND OF RELATIONSHIP do you have with your hospital administrators? That’s a question we explore in several stories in this month’s issue.

As our cover story explains, the ubiquitous role that hospitalists play can land them in awkward situations. A classic example is the 28-year-old MBA who wants to tell physicians where to begin their morning rounds.

Hospitalists may grumble that in this situation, at least, the administrator is viewing physicians as laborers who should do what they’re told, but there’s probably more going on. As physicians we interviewed for the story explained, the young administrator probably has a goal in mind, but simply didn’t understand what doctors did well enough to come up with a plan that works. Or he hasn’t set up the communication channels he needs with doctors to hammer out the best mutual approach to solving a problem.

Our commentary, which examines why some hospital executives jump on the discharge-before-noon bandwagon, comes to similar conclusions. Administrators think that discharge-before-noon initiatives will cost them little and yield big benefits, so they push discharges before noon as a new metric.

But as the opinion piece points out, early discharges can lead to perverse incentives that sabotage throughput and drive up length of stay. Hospitalists might actually hold off discharging a patient late one day to meet their incentive for discharging that patient before noon the next.

In both instances, administrators are struggling to meet a specific goal. But their lack of information about what hospitalists do is leading them down the wrong path, or they’re not sitting down with doctors to think a problem through together. These situations may be awkward, but they represent a chance for hospitalists to step up, weigh in on tough problems and work with administrators to solve them—as long as those administrators are willing to listen.

edoyleEdward Doyle
Editor & Publisher