In January, I served as one of about 140 screeners in the Jesse H. Neal National Business Journalism Awards competition. My category was "best single article" from publications with less than $3 million in annual revenue. My job was rating each of 35 entries I reviewed. My ratings, along with those of other screeners, would determine which of the entries would be forwarded to an expert panel of judges for final review.
What struck me most about the articles I read was that the majority of them were not written by reporters employed by the publications. Instead, freelance writers, experts in the field or consultants serving that particular industry wrote most of the articles. The articles were fine, workmanlike pieces of journalism. But they lacked passion. They lacked depth. They lacked perspective. They lacked the traits you would find in a story written by a good staff reporter-the backbone of any responsible publication.
The situation made me sad for the profession, which like many industries seems to be using more and more outside writers, who don't require costly employment benefits, to fill pages, rather than staff reporters, who do. I'm proud to say Modern Healthcare and Modern Physician employ 28 full- and part-time reporters and editors. We use freelance writers on occasion but only for special projects. And we try to use the same freelance writers for the same special projects each year to capitalize on their expertise.
Although we'd like to think so, the quality of our work doesn't often determine whether someone lives or dies. But the quality of the work performed in hospitals often does. So, you would think that a hospital administrator would be loath to delegate even the smallest function to someone not employed by the hospital. But as Michael Romano, an employed staff reporter at Modern Healthcare, reveals in this issue's special report (p. 24), hospitals can outsource practically anything to an outside company. In theory, it's now possible for one hospital to outsource every function, from the smallest administrative task to the most complex clinical procedure. As Romano suggests, the industry is on the verge of having its first 100% outsourced hospital. It's healthcare's version of the $6 million man. I can hear the marketing pitch now: "We've rebuilt it. We've made it better than before."
Now, this isn't to say that some hospitals don't have legitimate reasons to outsource. A shortage of nurses or physicians may prompt them to use a staffing company to fill their clinical needs. And this isn't to say that outsourcing companies don't provide good service or care. I'm sure many do, and they're able to provide a level of business or technical expertise unavailable to some hospitals. But I'm not sure what the point of being a hospital executive is if you outsource everything.
You're being paid to run a hospital, not to juggle dozens of outsourcing contracts. Or oversee someone who juggles dozens of outsourcing contracts. And I'm not sure a hospital can claim to be community-based if no one in the community actually works there as an employee. Many hospitals are outsourcing clinical and administrative services as a quick fix to cut operating costs, not because they lack a pool of available caregivers or expertise in information technology or business office functions. Hospital executives who don't make their margins are shown the door, and for those who find revenue hard to come by, the only way to make those margins is to cut expenses.
Outsourcing is a great business strategy when it fills a critical need or reduces operating costs that can't be achieved another way, but relying on it exclusively to make life a little easier is lazy management. For those who do, they may find the executive suite will be the next function to be outsourced.
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