In celebrating the silver anniversary of Crain Communications' publication of Modern Healthcare, this week's cover story highlights the events and people who have shaped the nation's trillion-dollar healthcare system.
Reviewing a quarter-century of coverage, it's interesting to see how little has changed. Despite rapid advancements in clinical equipment, sophisticated information technology and a raft of miracle drugs, hospitals still function much the way they did in the 1970s. And today's healthcare managers are preoccupied with many of the same challenges that faced their counterparts decades ago.
Ironically, hospitals can transplant vital human organs, but they have a hard time issuing bills that patients can understand. Healthcare systems have invested heavily in sophisticated computer technology, yet patients become frustrated when trying to make a simple telephone call to their caregivers. Physicians continue to view the hospital as a personal laboratory/piggy bank. Specialists unable to get their way in the 1970s and 1980s threatened to take their business to a competing hospital. Today they might open their own specialty hospital.
Hot buttons of the 1970s, such as healthcare inflation, nursing shortages and misguided expansion, are just as critical in the 21st century. Other 25-year constants include government regulation, tightened reimbursement policies and dealing with the burgeoning uninsured population.
For the most part, healthcare executives have guided their organizations around these barriers like ships' captains. In a way, hospital management seems to function best when confronting crisis and deadlines. And these managers have an uncanny knack for bouncing back from adversity. But as the adage goes, those unable to learn from their mistakes are destined to repeat them.
Resiliency is vital to the success of any enterprise. Even more important is an ability to analyze the impact of past decisions and outcomes and to use that knowledge as a framework for future strategies. A well-grounded organization usually has leaders who respond to opportunity but avoid fads-especially the second time around.