More Evil Administrators

This is from Maine, where I practiced for 18 years:

Seven physicians — including four in the emergency department — are resigning from Maine Coast Memorial Hospital in Ellsworth.

Hospital officials say the departures are due to changes the hospital is making to improve quality. But other physicians who have left in recent years say the turnover stems from the administration’s increasingly caustic relationship with providers.

Do you see the pattern?  I have spoken about this before and have seen it over and over in my own life.  Administrators want control and they want doctors to shut up or leave.   They have a delusional sense of self-worth.  More from the article:

  • Speaking on condition of anonymity, one hospital physician said that doctors who are leaving are reluctant to be interviewed for fear that hospital administration will retaliate as they seek other jobs
  • “The medical staff has not felt for a long time that the administration has any respect for the medical staff or the nursing staff,” he says.
  • Williamson says the dysfunctional dynamic has effectively forced many medical staff out. By his count, 30 have left the hospital over the past five years. He says some positions haven’t been filled, leaving the hospital understaffed.

Vindictive, patronizing, disrespectful, and indifferent to our needs.   That about sums it up.

This is what I was seeing all the time up there but it happens everywhere.  It is a massive power play by administrators.  They have the perfect excuses, too.  More from the article:

But the president of Maine Coast Memorial, John Ronan, who has been leading the hospital for about a year, says the turnover among the hospital’s 55 providers is typical of hospitals.

“I attribute a lot of it to change and a different way of looking at how we provide services here,” he says.

Maine Coast Memorial was acquired by Eastern Maine Healthcare Systems in 2015. Since then, Ronan says, the hospital has made changes to improve quality, such as establishing a collaborative that allows doctors within the system to fill shifts at various emergency departments depending on need.

Some doctors, he says, may not find these new strategies palatable.

“We want to reassure the community that while there has been some turnover with providers, it’s still great care here and we’re still working through plans to make it better care than it has ever been,” Ronan says.

And my favorite double-speak example:

The chair of the board at Maine Coast Memorial, meanwhile, is expressing confidence in hospital leadership. In a written statement, Debra Ehrlenbach says the plans that have been developed in partnership with EMHS will “position us for long-term success in a changing healthcare world.”

Seems like they choose a position to lose more doctors.  But since she and other administrators feel doctors are interchangeable, and another one can be plugged in, then it doesn’t matter.

Since some idiot ragged on me for being too jaded against administrators (I am and for valid reasons) I decided to continue to show examples of their true intentions.

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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] 

  6 comments for “More Evil Administrators

  1. Sir Hakum of Hugo
    September 25, 2017 at 9:29 am

    Can Scotty use the transporter to beam all the Adminatribbles into the Klingon engine room? Poor poor Klingons….

  2. Steve O'
    September 24, 2017 at 11:13 am

    I see a parallel. I do not want to pick up the argument going on about sports, but I note:

    “Wouldn’t you love to see one of these NFL owners, when somebody disrespects our flag, to say, ‘Get that son of a bitch off the field right now. He is fired. He’s fired!”
    “Total disrespect of our heritage, a total disrespect of everything that we stand for. Everything that we stand for.”
    “If a player wants the privilege of making millions of dollars in the NFL, or other leagues, he or she should not be allowed to disrespect our Great American Flag (or Country) and should stand for the National Anthem. If not, YOU’RE FIRED. Find something else to do!”

    A different voice, that of a surgeon at a different time:

    Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire the skill? That was what I could not place at the disposal of men whose sole qualifications to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun.

    Dr. Hendricks, “Atlas Shrugged
    The owners of hospitals or NFL Teams consider that employees are simply wind-up toys who are told to do what they are hired to do, and fired if they disobey – even if the disobedience is about something utterly unrelated to their skills.

    A very sharp advisor of America, George Will, wrote an essay America’s Engine Is Being Slowed by Complacency. What he sees is that “We are taking fewer risks, clustering among like-minded peers, and running on autopilot.” The reason is that we live in big slow bureaucracies driven by big slow rules, and the rule is that accepting barely-tolerable mediocrity is far superior to allowing employees to be independent or human in any way.

    The sports industries – the NFL and Major League Baseball – are now completely reformed to the industrial level. Each team is homogenous, so it is difficult to know what a team comprising only skilled athletes would produce. Skill is a benefit only in the most minor sense. Not standing when you are told to stand is far more important.

    It is a bit ironic that the National Football Industry is discussing firing employees who do not do what they are told, and that another cog in the football industry – PennState – has returned to full respect after institutionally endorsing and procuring children for rape. Which is more shameful – standing for the National Anthem, or child abuse? The answer is, follow the money.

    There’s a hell of a parallel in medicine and sports. In the old days, residencies were somewhat like sports teams – throw together talent and make them work out hard. Now, residencies and academic medicine is like an ice-cream cone: Lick you way to the top.

    Read George Will. We become what we choose to be. The hospitals will hire barely-functioning ignorants to see and treat patients, as long as they appear to worship the paper-shifters and their instructions. If people are too well educated, they become stubborn when confronted by bad suggestions and instructions. A little complacency goes a long way. Authoritarians get it.

    • Pat
      September 24, 2017 at 9:36 pm

      Steve, with greatest respect, I read George Will assiduously for over 25 years, and hereby acknowledge his brilliance. But even in the early 1990’s, when anyone made a vigorous argument against the centralization of power, Will became a scold and referred to such sentiments as “unlovely.” Like too many pols, he has been fervent when it wouldn’t count, and reticent when it would. He backstabbed his Buckley-root mentoring, and became more John McCain than Goldwater scion, more interested in being adored at Georgetown get-togethers than in actually achieving reform (And yes, I dismissed that bastard as a useful voice before the current president ran for office).

  3. Pat
    September 24, 2017 at 8:32 am

    “Establishing a collaborative that allows doctors within the system to fill shifts at various emergency departments depending on need.”

    Translation: if you want to work in your own ER, you will have to fill in at other ER’s as we need, or be fired. Guarantee this “collaborative” will not involve extra cash for the doc, just more work, more driving, less holidays off.

  4. Mary Lang Carney , MD
    September 24, 2017 at 7:15 am

    At Presence Health in Illinois s similar scenario.
    They decided that some of the hospitals’ ER were underperforming. Ours was not.
    They got rid of a group that had been there for more than 30 years. All excellent physicians used to the community, involved in the community. And now the younger inexperienced MDs from the new group are not meeting the guidelines, etc.
    They were better off with the other group.

  5. September 24, 2017 at 7:12 am

    See the original Star Trek episode, “Trouble with Tribbles”. They are cute and furry but they are also purposeless, ravenous, and ‘born pregnant’ -having one means that it will hire DROVES of them to ‘tackle new challenges’.

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