Few hospital administrators have spent as much time in a hospital bed as Sekander Ursani, M.D. A nearly fatal car accident on an icy day in January 1996 landed the board-certified emergency physician in intensive care for 50 days. After emerging from more than 30 days in a coma, Ursani began to appreciate how inefficient hospital care can be.
"I saw healthcare from a different perspective being a patient in a trauma center and also being a patient (in a rehabilitation hospital)," he said.
At the time of the accident, Ursani had been director of emergency services at West Jersey Hospital-Berlin (N.J.). In November, he won the newly created executive director post. Although he's still getting used to running the show instead of seeing patients, the Pakistan native has focused on making things better for patients. Now, when the emergency room isn't overwhelmed, patients are routed directly to a bed. Instead of waiting between diagnostic procedures, a patient can have his or her X-ray, lab work and an electrocardiogram completed consecutively.
Ursani, one of just two physicians leading hospitals in New Jersey, also is attempting to topple the "us and them" rivalry dividing physicians and administrators. "I've told them if there's any issue that needs to be addressed, not to address it in a public patient-care area. Come and talk to me personally."
Beyond anatomy.Some University of Southern California medical school students have decided to augment their already overwhelming curriculum by learning about the real world of healthcare.
A field trip to the struggling LAC-University of Southern California Medical Center in 1995 "opened our eyes to the very real challenges that doctors and others face in an attempt to deliver quality care," said Amal Trivedi, a second-year USC medical student.
He and two other students concluded that the basic social and economic underpinnings of the medical system are not being addressed in medical school curriculums. "In meeting with other students, not only did they not know very much about our healthcare system, but what they did know filled them with a sense of dread rather than opportunity," Trivedi said.
Trying to shed some light and hope, the students formed Medical Students Organized to Create Activism and Leadership with a goal of educating students about the challenges in delivering quality healthcare.
"Since the face of medicine is changing, our training as physicians must include knowledge about health policy, patient advocacy, market forces and humanism. Understanding health policy and the issues involved in healthcare reform are just as important in the healthcare toolkit as anatomy," Trivedi said.
The group's first event was a symposium in Los Angeles last month featuring leaders in healthcare and healthcare policy. They included Alain Enthoven, a professor of health policy at Stanford (Calif.) University's graduate school of business; John Lewin, M.D., head of the California Medical Association; and Rand Corp. directors and fellows. The symposium was available live on the medical school's World Wide Web site for about 25 participating medical schools.
Speaking of money.Outliers has heard talk is cheap. But whoever said that evidently hadn't seen a recent front-page story in the Philadelphia Inquirer on executive pay packages at not-for-profits in the Philadelphia area. Allegheny Health, Education and Research Foundation spokesman Thomas Chakurda, a vice president, pulled down $249,691 in salary and benefits in fiscal 1995, the most recent year for which the Inquirer could obtain tax filings.
That cool quarter-million placed Chakurda 73rd on the Inquirer's top-100 list, ahead of eight area hospital presidents. But compensation's all relative, we suppose. Compared with his boss, Chakurda's working for chump change. Sherif Abdelhak, AHERF president and chief executive officer, had a 1995 salary and benefits package of $1,216,757, up 24% from 1994, making him top dog in the Inquirer report.
Days of future past.While hordes of computer programmers at most software companies strain to retool dates for the year 2000 (See cover story, p. 98), a Seattle-based company with a sense of history can rest easy knowing its solution was nailed down long ago with a golden spike.
Nearly 20 years ago, the original designers of the Phamis healthcare information system decided to determine the passage of time based on a "relative date" somewhere in the past rather than on two-digit year designations, said Charles Reiling, senior vice president for client services.
"Internally, the system doesn't much care about the century or the year," Reiling said.
That's because all date references are counted from May 10, 1869. It could have been any date plucked out of the past, but the computer pros settled on "the date that the golden spike was driven into the Continental Railroad," said Phamis spokeswoman Heather Miller. "(Software designers) were just looking through some history book and decided it would be an event of some significance and they would start there," Miller said. The only requirement was that the date had to be older than the birth date of any living person at the time they set the clock.