28
February
2007
So I am in HR now and it is actually pretty interesting. I feel like I am in a foreign country and am learning their language and culture. Their focus is very different than the focus of hospital operations. HR folks have particular expertise - labor law, recruitment strategy, benefit administration- and that is their world. They apply their knowledge in support of the hospital, but they are at least one level removed from what is going on in the hospital. Instead of the daily census, patient records, and practice guidelines, HR folks focus on requisitions, employee files, and compensation programs. I am not knocking HR. What they do is really important for the hospital, but I am seeing that this disconnection between HR and hospital operations really limits HR’s impact on the later.
I think it is no secret that HR has not typically been seen as a strategic partner in the past. Many HR departments focus on the transactional work of moving paper around. This, of course, is a great service to the hospital, as much of the paperwork is required for legal compliance. HR also deals with those technical, but important hiring/firing/benefits/compensation issues, so that operational managers don’t have to, but, honestly, these are not seen as high value activities. Oh, and HR folks are also good for dealing with unions.
The good news is that HR can play an incredibly strategic role within the hospital. It just takes a little change of perspective. What is the biggest category of cost for every hospital in America? That’s right, labor. So who owns “labor”? The manager. Yes, but also HR. HR recruits for vacant positions, so that nursing doesn’t have to call upon agency nurses. Got employees with strained backs from lifting patients all day? Go see your friendly employee health nurse (often associated with the HR function). Got employee morale problems. Let an HR organizational development specialist facilitate a teambuilding, offsite activity. Are you a bad manager? We’ve got training courses for that too.
Of course, many HR departments do these things already. But filling job requisitions and providing training courses is not the ultimate measure of success for HR. The secret is leveraging these skills to achieve hospital strategic, financial, and operational goals. If you can focus your HR folks on these things, then HR can truly be a strategic partner.
Posted: Leading Healthcare
14
February
2007
We have all seen the adds for prescription drugs and we all know the impact they have had on utilization. Once the pharmaceutical companies started direct to consumer advertisements, utilization of the advertised drugs shot up. It seems the medical device industry was paying attention. This weekend I saw an ad on TV for Zimmer’s “Gender Solutions” knee implants - and get this - they are “shaped to fit a woman’s anatomy”.
Presuming that this will become a trend, the impact of this commercial will be far and wide.
From a hospital strategy perspective, I would revisit my orthopedic volumes after seeing this commercial for sure. I think there is no doubt that commercials like these will translate into higher demand for surgeries. But what about medical necessity, you might ask? There shouldn’t be more knee replacements unless baby boomers start playing more one on one, right?
Not necessarily. Along with direct to consumer advertising of pharmaceuticals, we have seen another trend: the medicalization of problems that went untreated in the past (there may be a better word than “medicalization”, but I think it does the trick). Now I am not a doctor, but there seems to be a new class of drugs available to treat, for lack of a better descriptor, free-floating symptoms. A drug like Zelnorm, for instance, is advertised to treat “bloating” and “irritable bowel syndrome.” I saw another advertisement for a drug to treat “restless leg syndrome.” We aren’t talking cancer here, but we are creating medical solutions for quality of life issues (again for lack of a better term).
And of course the king of all advertised pharmaceuticals, sexual performance enhancing drugs, leads me to my next point. The arrival of artificial knees designed specifically for women ushers in the era of science and medicine improving the human machine. Today we can get knees that are more comfortable, tomorrow we will have knees that “last forever” or improve our performance on the football field. Combine the trends of consumer driven healthcare with advances in medical devices and even genetics and we could be looking at a healthcare industry that is radically different from the one we have today. Of course there are many ethical considerations here (don’t worry ethicists are standing by to take your calls as they have been anticipating this for a few years now), but have we considered the impact on the healthcare delivery system? Will these advances only be available to those that can afford it? Will our focus on prevention and healing shift to a focus on improvement and replacement? Will your blown out knee become your bionic knee?
Who knew a knee could have such an impact?
Posted: Healthcare and Technology
6
February
2007
It happened a few weeks ago. I was meeting with one of the managers from our department, discussing a project we were working on together. We were discussing some challenges allocating her direct reports time among various projects, when all of a sudden I saw my colleague as…a manager. It was as if a new pair of glasses had been lowered over my eyes. We were discussing a problem and rather than try to solve it for her, I let her deal with the problem, because she is a manager and that is what managers do.
OK, I know that doesn’t sound earth shattering, but many people managers don’t use this lens all the time. The assertive, go-getters see problems and they go and fix them. The caretakers try to make things easier by taking problems off of other people’s plates. There is nothing inherently wrong with these activities, but often the result is a habitual working at one level below your pay grade - directors do the work of managers, VPs do the work of directors, and so on.
Looking at people through this lens is actually quite freeing. For one, it clarifies boundaries. I don’t have to do the work of the manager. That is what the manager is for. I do have to do the work of a director (what ever that is) and I can lean on my VP for executive level support. That doesn’t mean that you can never step outside of your role to lend a helping hand, but applying the lens consistently empowers people to solve their own problems and come to you for problems that you can solve.
Healthcare managers are very busy people. There are high demands on us and limited resources. Too often we get bogged down in the daily grind of putting out fire after fire. But if you put on the lens, you may realize that you aren’t a fire fighter after all. Taking the metaphor a bit farther, looking through the lens you may realize that you are a dispatcher and instead of sending fire fighters out into the field, you were out there yourself manning the hose.
Posted: Leading Healthcare
