All hail physician-executives
Hooray for Larry Hollier, M.D., at Mount Sinai! The time has come for more qualified M.D.s to lead America's hospitals ("The doctor-exec is in," Sept. 30, p. 6). Some lay administrators do contribute much-needed financial and managerial expertise. Yet in my experience, many more lack the basic clinical knowledge and specialized training essential to long-term success in today's complex health environment. Across the country, hospitals face a disturbing double standard. Highly educated medical personnel are often required to possess postgraduate credentials and face rigorous recertification standards. Meanwhile, they also are required to follow the daily directives of lay administrators with no postgraduate degree in hospital administration, no common commitment to continuing education and no credentials other than honorary fellowships or certificates issued by one of several self-styled, self-serving professional organizations. For these lay administrators, success is owed more to simple cronyism and tireless networking than to professional competency or proof of leadership. The same loose standards that for so long have infected the leadership ranks of the business world also have compromised the health of our nation's hospitals. Not all M.D.s are qualified to lead, but at a minimum, patients and the public alike can rely on certain credentials that objectively benchmark their knowledge and standing within the medical community. While these credentials alone are not enough, they are an excellent start.
(Former administrative director of
international services at Mount Sinai
Medical Center in New York)
Doc-exec transforms hospital
Ienjoyed reading the cover story. On Jan. 3, 2001, the board of Mercy Health Partners-Kentucky/Indiana Region in Paducah, Ky., selected William Wheeler, M.D., as the president and chief executive officer of Lourdes Hospital. By the end of his first year as CEO, our physician satisfaction scores improved by 11%, employee satisfaction scores improved by 14%, patient satisfaction scores improved by 17%, and total patient volume increased by 9%. A remarkable first year for the doctor-CEO, and 2002 is even better.
President and chief executive officer
Mercy Health Partners-Kentucky/
Docs cost more, but are worth it
In our work, we see two major reasons why few hospital boards decide to hire physicians as chief executive officers. One is that it simply doesn't occur to them. Their consultants don't recommend this option and many board members don't have experience with physicians who are CEOs. They don't know how well it can work. Second is that it costs more. The market has set the compensation level for physician-executives higher than for nonphysician executives. An equally educated and experienced physician-executive can command a higher salary than a comparable nonphysician executive. So when boards do look at this issue, they see an expense instead of the investment that it really is.
Physician Executive Management Center
Specialty hospitals are a hot topic
I read with great interest your recent Modern Healthcare piece on specialty hospitals "It's really brother vs. brother" (Sept. 30, p. 20). We have been seriously studying this issue for some time as well, and independently arrived at many of the same facts and conclusions you did. We greatly benefit from your magazine. Keep up the great work.
Money won't solve shortages
I think you have it mostly right in your comments in response to the nurse shortage "The best revenge" (Sept. 23, p. 20). Much of the problem is caused by the hospital-nurse relationship and poor structures and processes of relationship and empowerment. There is a clear need for models of shared governance and shared leadership in healthcare, which can be illustrated by most of the magnet hospitals, where such approaches have resulted in lower levels of turnover.
This is not new information. I think the fact that we don't see more of these approaches is more a sign of deficits in leadership than problems with nurses. I agree with you-it is a self-inflicted wound. As far as Kaiser Permanente spending all that money on accommodating its one-to-four patient ratio at the cost of over $150 million, I'm thinking that if that money could be spent on recruiting and educating nurses in California, the nursing shortage for the entire state would be resolved. It appears to be just another example of misplaced resources spent on a solution whose time is past and whose relevance to the issues of appropriate use of nurses is suspect. Here we go again.
Tim Porter-O'Grady Associates
President, Georgia Nurses Foundation
Competition could get ugly
Your editorial is right on point (Sept. 30, p. 20). Healthcare is most competitive within itself, but just think how ugly it would be if we had to deal with foreign competition like the automobile industry.
President and chief executive officer
Physician Surgery Centers
Regarding your article "No contest for ex-AHERF chief" (Sept. 2, p. 6): In the 1990s, as a result of numerous hospital mergers and acquisitions, you could have placed a sign outside your office door that read "Acquired Healthcare Co." and you would have been correct about 50% of
I update my resume about once a year to rename the ghosts that were once vibrant organizations and no longer exist, the Allegheny Health, Education and Research Foundation among them. Thank you for your coverage of what is surely one of the most outrageous sagas in the annals of modern medicine. Healthcare executives, are you listening?
Arthur Lazarus, M.D.
Make survey more meaningful
Your Contract Management Survey (Sept. 2, p. 28) is based on information provided by outsourcing companies and not from healthcare facilities, which calls into question the survey findings.
The numbers really tell your readers little. Changes from one year to the next are meaningless because of all the acquisitions and mergers. Another problem is that the companies that make up your "top" contractors change from year to year. This means no meaningful year-to-year trends are available.
Technomic Consultants, Chicago, has taken another look at its outsourcing numbers for the healthcare food-service industry and found that contractors make 20% of such purchases.
A year ago, however, it published numbers that indicated 45% of hospital food purchases and 24% of nursing home purchases were made by contractors. We applaud Technomic's forthrightness in taking another look at its numbers and making the correction. We encourage Modern Healthcare to do the same and take steps to make your annual survey meaningful.
National Society for Healthcare
Food Service Management
Regarding your Outliers item (Sept. 9, p. 36) about Preston Bergin, a cardiac catheterization patient turned away from Memorial Hospital-Ormond Beach (Fla.) because he was deemed too heavy for its operating table: My husband was overweight and Thomas Martin, M.D., of Shands at the University of Florida in Gainesville took him as a patient. The tables there would hold Bergin.
If you could tell him to contact them, I am sure the people at Shands would be glad to assist him. They will also assist him in getting coverage for the procedure if his insurance does not cover it.
Chief nursing officer
Carolinas Hospital System
Lake City, S.C.
I'm very disappointed by your ranking of the healthcare industry's 100 Most Powerful People (Aug. 26, p. 6). The omission of Alan Miller, chairman and founder of Universal Health Services, is a glaring oversight. Miller founded the company 24 years ago and has grown it successfully both in its commitment to quality care in the communities it serves as well as financially for its employees and investors.
Alan has received high honors from numerous prestigious organizations both in and out of healthcare. Without fanfare, he has made generous contributions in time and money to educational institutions, the arts and healthcare organizations. I hope your magazine and its readership realize this oversight and appropriately recognize Miller for his valuable contributions to our industry.
Senior vice president
Universal Surgery Centers
Universal Health Services
Fort Worth, Texas
Your editorial regarding HealthSouth Corp. "The Scrushy Complex" (Sept. 9.
p. 24) is misleading and factually incorrect. You used typical editorial license and used portions of facts, turning them the direction you wanted to go in support of your personal opinion and bias. I would think you would have more integrity than that, especially when you are lambasting the integrity of others.
Area manager of outpatient
for the North Texas region
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