It’s Always the Administrators


Why is healthcare so expensive?  Well, I have pointed out before the 3000% increase in administrators.  Sure there are other reasons but this massive load of “workers” who produce no income for the system happen to the a major anchor drowning us all.  Did you know that education and healthcare usually track together? They do.  Remember the useless quality indicators?   It seems teachers and doctors hate them equally.  Guess who is imposing them on us?  The administrators!   Well, it seems even higher education (colleges) are feeling the same way as doctors. See this article in the NY Times.

  • By contrast, a major factor driving increasing costs is the constant expansion of university administration. According to the Department of Education data, administrative positions at colleges and universities grew by 60 percent between 1993 and 2009, which Bloomberg reported was 10 times the rate of growth of tenured faculty positions.
  • Even more strikingly, an analysis by a professor at California Polytechnic University, Pomona, found that, while the total number of full-time faculty members in the C.S.U. system grew from 11,614 to 12,019 between 1975 and 2008, the total number of administrators grew from 3,800 to 12,183 — a 221 percent increase.
  • The rapid increase in college enrollment can be defended by intellectually respectable arguments. Even the explosion in administrative personnel is, at least in theory, defensible. On the other hand, there are no valid arguments to support the recent trend toward seven-figure salaries for high-ranking university administrators, unless one considers evidence-free assertions about “the market” to be intellectually rigorous.

We need to remove the administrator bloat in healthcare and education because they are drowning us all.  As Administribbles continue to multiply they will only increase their salaries more and more because they are the ones signing the checks!!

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “It’s Always the Administrators

  1. JoAnne
    April 12, 2015 at 10:26 pm

    Once upon a time a person, who was sometimes a “patient”, saw a provider for health/sickness care. The provider probably had an assistant and a receptionist/secretary, at a small office in a modest place. The reasonable costs were paid by the patient, who was sometimes reimbursed by their insurance, especially if something really bad had happened and the costs were really big.
    Now that same transaction is going to require the basic players above, plus at minimum an IT specialist (federally required), a coder, a prior authorization clerk, 3 or 4 people at an insurance company trying to come up with some way to not have to pay for the actually $5 worth of care or product that the patient doesn’t think they should have to spend one cent on.
    It’s no wonder health care costs are going up exponentially. And I haven’t even included all those administrators yet.

  2. Steve O'
    April 7, 2015 at 9:13 am

    What is becoming much more frightening is the general acceptance of the “administrator as legitimate job.” One of the most frightening questions in academia, business medicine or government is “What is it that you do?” Point to the name of the agency or its mission statement, and ask “How does your job serve the mission of the company/agency/clinic?”
    There are massive numbers of individuals with no skills who are entrenched in jobs that produce nothing of value. They fight like political animals in a cage for their “right” to occupy that chair – fundamentally anxious that there are many others who can do the job, if there is anything to be done.
    The administrator has become the equivalent of the Byzantine bureaucrat. If the whole world is turf and struggles and secret methods to wormhole problems through a convoluted corporate system, that becomes the aim in itself.
    Such people innately distrust and try to crush anyone who has individual skills. If a doctor can diagnose and treat an illness in an uncontrolled fashion, why then – the doctor is threatening the organization just by mere competence. He/She must be harnessed into needing the plethora of rubber stamps which the organism survives by.
    Militaries are famous for this. They tend to attract men who are vain and love to dress up with glitter; but who likewise fear independent thought as much as they fear physical combat. Every military has a knapsack of hangers-on and moochers that ride on the shoulders of every combat infantryman – a dozen or two bureaucrats-in-uniform who claim responsibility for that man’s victories, but blame him for defeats. Most military forces swagger with the weight of incompetent administrative peddlers, who claim their rights and rank solely because of the worship of the bureaucracy.
    A seven-digit income SHOULD go to the senior office administrators in the corporation, they assure themselves – why, without that, they could not defend against the attacks of the bureaucracy of the State Regulators, the Federal Agencies, the intricate demands of the dance. They are the ones that worship ICD-10, a concept that a million jobs rides upon its shoulders; a million USELESS jobs.
    But since there is no shame in the American workplace, each one of those million proudly drives to work, and derides those who do something, who do the job. “I code, therefore I am as important as the eye surgeon who operates.” Hubris and vanity – they’re here in spades.

  3. Perry
    April 6, 2015 at 11:38 am

    And administrators just love buzzwords like patient-centered, quality, patient engagement, medical home, EMR etc ad nauseum.

    • Steve O'
      April 7, 2015 at 9:20 am

      The buzzword du jour is the Profession of Faith in every bureaucracy; the creed of the day is vital to sorting out ones rank. If the COO issues the acronym “Caring-Responsibility-Attitude-Professionalism,” and butters it up with client-centered, evidence-based word salad, then it echoes around the intellectual dog park that constitutes most boardroom, picked up in the unthinking chatterers in suits, moving forward, low-hanging fruit. they have mandatory C.R.A.P. seminars out in the boonies, and give out pins that say “I’m C.R.A.P.!” Like the new pet toy, as the attention span wanes in the corporate office, some new syllable salad is spewed forth under the solemn pretense that it is an idea, not merely entertainment for the bored.

  4. Pat
    April 6, 2015 at 11:13 am

    And yet those same institutions of higher learning all have their hand out for every scrap of federal and state money they can beg. Yep, that’s a parallel.

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