Full Metal Administralian: The Language of Distraction

The biggest hospital system in central Maine is having major issues and I have some things to say about it.  I worked there for five years and know some inside information. It seems a new CEO came in two years ago and began changing things to make it more profitable.  I also hear he is not a good communicator and is not well-liked, which is causing physicians to leave in droves.  “Most of the doctors you knew have left, Doug” is what I have been told.

Central Maine Healthcare oversees three hospitals and all three had medical staff meetings whereupon each gave the CEO a “no confidence” vote.  That is an amazing statement as doctors hardly ever work together to come to a consensus.  In other words, it is really hard to piss off enough doctors to cause them to push for your ouster.  I don’t know all the details of what this CEO did but the rule of thumb is that if administrators could get rid of all doctors then they would.  It would just make their lives easier and they would save money.   If I had to bet then I would say that this is going on here but it doesn’t really matter.  What I really want to talk about is what I call the language of Administralian.  Some say it was created decades ago by the first businessmen who ran hospitals.  I have no proof of that.  All I know is that these two articles, about this system in Maine, use the art of bullish%t to the extreme.

Exhibit #1: Central Maine Healthcare leaders will ‘carefully consider’ no-confidence vote on 7/31

This article came out after ALL the hospitals gave the “no confidence” in the CEO.  Read it for the full flavor but here are the prototypical ADMINISTRALIAN language phrases used:

  • “Importantly, it reflects a divided medical staff and speaks directly to the importance of communication and collaboration between senior leadership and our medical staff on how best to move CMH forward,” the statement read.
  • “We have a deep respect and appreciation for the many contributions of our medical staff and will carefully consider this feedback as we work through next steps.”
  • “These are challenging times for community hospitals and we are no exception. The CMH board takes its fiduciary responsibilities very seriously. Last night’s vote by the CMMC medical staff affirms their frustration and concerns with issues impacting our organization and required system changes. Importantly, it reflects a divided medical staff and speaks directly to the importance of communication and collaboration between senior leadership and our medical staff on how best to move CMH forward. We have a deep respect and appreciation for the many contributions of our medical staff and will carefully consider this feedback as we work through next steps.”

How brilliant is that!!  Let me translate for you.  The first sentence is a bogus acknowledgement and means nothing. It is the famous “I hear you” line. The second sentence is intended to blow smoke up the doctors’ asses. The doctors are made to think, “Great. They get us.”  The third sentence is the old switcharoo whereupon they place the blame on something else, that being communication.  It takes the attention off the CEO whom the majority of doctors hate and places it on an inanimate object.  It is also another acknowledgement that they “hear” the doctors and they are really racking their brains to fix everything.  This is all a set up.

Exhibit #2: Central Maine Healthcare board backs CEO on 8/1

This article came out ONE DAY LATER! Good thing they really thought about things.

  • “The board’s action is guided by our fiduciary responsibility to CMH and its mission, meaning that it is our responsibility as board members to act in the best long-term interests of CMH including ensuring that it remains financially viable,” Avasthi wrote.
  • She said the board also agreed to add more doctors to the board and to allow seats for the chiefs of staff of Bridgton Hospital, Rumford Hospital and Central Maine Medical Center in Lewiston. It also agreed to create a joint council composed of senior leadership, board members and hospital medical staff in an effort to improve communication among those groups.
  • “We believe these are significant changes providing the medical staff substantial input into governance of the system,” the memo read. “In addition, the board will continue our engagement with an independent consulting physician to monitor and update the board on physician feedback.”
  • “We have heard the concerns and frustration voiced by some,” she wrote. “We recognize that this has been a tumultuous time. We know that these concerns are voiced out of dedication to your work, your patients and your hospital.”
  • “We also recognize that it is a difficult time in health care, particularly for community hospitals. We must adapt to ensure the long-term viability of the system and that means change — sometimes difficult change.”

Let’s translate.  The first sentence means the obvious.  Fiduciary = money. The second proclamation is a peace offering that, once again, means nothing.  They are just placating the doctors.  The third sentence uses big words like “governance” and “engagement” to confuse the physicians. I have mocked the term “engagement” for years as it is a garbage term that no one understands.

I do like the idea of a pro-physician consultant but most, if not every, consultant is pro-administration and the doctors can smell a rat immediately.   The last two sentences are great because they use the cliche “I hear you” and throw in the old “recognize the tumultuous time”, which is music to my ears.  They are almost a caricature of someone spoofing administrators.  They finish it off with the cherry on top by closing with “and that means change — sometimes difficult change”. Perfect.

This whole thing is textbook ADMINISTRALIAN.  I coined this term for the Placebo Journal years ago because it is pervasive in this industry.  These two articles prove it.  Hardly any doctor likes this CEO, yet the board keeps him and their statements show they are playing one big shell game trying to confuse anyone trying to follow along.  Do they think doctors won’t see through this?  I guarantee that any doctor who was on the fence about leaving this system will be leaving now.  It will also make it very hard for patients in that area of Maine.  This is the saddest part.

Now for some fun facts.  Two of the hospitals voted unaminously in the no-confidence.  The third, and biggest hospital, had a 6 hour meeting where those physicians standing up pleaded for anonymity in case the CEO was not fired.   He wasn’t.  The vote went 100-66 against the CEO. How scared are some of these 100 doctors now because I guarantee some of these 66 will snitch?   Oh, and which doctors do you think will be chosen for those board seats? I bet it won’t be one of those 100.

Good luck recruiting doctors to this hospital.  Maybe they will just replace them all with MLPs?

All in all, the Administralian used here was a case study that could be taught for generations to come.  Lastly, it shows how little the opinion of the medical staff means to the powers that be.  Isn’t it about time this changes?

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