Do You Have ‘Administrative Harm’? Of Course, You Don’t….Anymore.
Get ready my DPC friends. A new term is being thrown around to “help” doctors. I recently read this article on Medpage Today and had to laugh. Here are some tidbits to read but don’t spit out your coffee while reading.
Clinicians have long understood that administrative decisions can cause harm, both to themselves and to their patients. Now, a term for the phenomenon is gaining wider recognition — administrative harm.
And..
“More decisions are being made by people very far from patients, and there’s no accountability, especially compared to physicians,” O’Donnell told MedPage Today.
Ya think?
Administrative harm is another term for being employed by a hospital. It wasn’t always this bad but it was always there. How does this article recommend fixing it? Put that coffee down again.
Strategies can be implemented immediately by clinician-administrators to help alleviate administrative harm, Burden added, such as taking “administrative time-outs. Are you taking a pause before you make a big decision? … We see this in the operating room, and in aviation, high-risk situations that use checklists.”
A second strategy would be committing to doing look-backs, so administrators can “constantly improve and do better,” Burden said.
Finally, she called for inclusive decision-making, a collaborative effort where diverse perspectives — including those of clinicians — have a say in how deeply an administrative decision will impact clinical care.
Administrative time-outs? Look-backs? Inclusive decision-making?
Seriously? Patient care decisions should ONLY be made by doctors.
The whole thing is just another fad. I really couldn’t figure out whether the term administrative harm was about helping the patients or the doctors. I guess both. Here is another quote that finally made sense:
One metric could be turnover or attrition, he said: “Administrators should be rated on the morbidity and mortality of their staff, and part of that is, who is still here at the end of the year. It would be really telling if there are very different rates for different administrators.”
The bottom line is that being employed by a hospital sucks. Unfortunately, a lot of doctors can’t get out of the system. Some can but choose not to. For them, I recommend they choose wisely and consider DIRECT PRIMARY CARE OR DIRECT SPECIALTY CARE.
I found the following in the conclusion of the JAMA article (link provided in the MedPage article). Administrator growth expected of 28% and physician growth of 3% on top of the administrator growth from the 1970’s to 2013 based on the popular graph of administrator vs physician growth over the last 40 years. “Houston, we have a problem!”
Consideration of the broader health care landscape in which AH operates is important. In the US, health care spending surpasses that of any other country, with administrative roles emerging as one of the fastest-growing sectors,2,31 with a 28% projected increase in medical and health services manager jobs from 2022 to 2032 compared with physician projected growth of 3%.32 A related change is the increase in private equity investment in health care. While investors with a profit motivation have long been involved in health care, the recent increase has been substantial, particularly with regard to physician practices.33 The association between investors’ acquisition of health care delivery organizations and negative clinical outcomes has been reported.6 These findings highlight the importance of understanding the interplay of administrative decision-making by health care leaders for both care recipients and the health care workforce.
WTF?!! i spit out my coffee Doug. They will never learn.
PATIENTS+ DOCTORS=good healthcare.