Featured column: No Hospital for Old Men

Health care is becoming an increasingly data driven and quality driven industry. Those of us somewhat “mature” physicians do, at times, savor memories of medicine’s more gilded years. Doctors were rock stars. I worked as a nurse’s aide in high school, and we stood up when the doctor entered the nursing station. When I started practicing medicine in the hospital setting, there was parking right by the door, free food in the cafeteria, and if you needed a few meds, well, that was free too. 

Now you have to sign, date, time, code, comply, conform, reconcile, accredit, credential, core measure, certify, recertify, and be a computer whiz. The rock star has become a provider, and he or she gets in the line with everyone else—and it’s a good thing.

The trick is to get medical staff members and hospitals to connect in an environment that, to some extent, is increasingly adversarial. Medical staff leadership and institutional professionals need to form a strategic plan that clearly addresses common interests, and both parties need to take a more positive perspective. For instance, instead of “Look, we have to hit these heart failure targets or we’re screwed,” medical staff leadership should present the notion that “We do some of this routine check-off stuff and we get great ratings for quality and our market share goes up.” Or, instead of “Oh, no–not another form to fill out,” change the dialogue to “Who wants to be in the picture for the newspaper when we promote our five-star rating on patient safety?”

The most important thing that medical staff leadership and their institutional counterparts can do is communicate the urgency of playing the data and outcomes game and playing it well. If you can’t demonstrate quality and compliance, you won’t have any business. Plus, it isn’t hard to do any of it. Annoying and a bit tedious maybe, but overall, it isn’t hard and doesn’t take all that much time. Whether it is dating and timing orders, documenting left ventricular function and beta blockers, or giving the antibiotics on time, it isn’t any harder than brushing your teeth. 

Your medical staff needs to know that life and business has changed. But the essence of the profession hasn’t—at the end of the long day, after all the paper work and hassles, the physician touches lives in a way that few can, and what they do matters deeply.

Alan Muskett, MD, is the medical staff president at St. Vincent Healthcare in Billings, MT. He can be reached at alanmuskett@gmail.com.