Hospital Employment Crisis

You may not have heard but hospitals are worried about an impending employment crisis. Is it about the nursing shortage? No. How about retaining great doctors? Nope. Instead:

More than half of hospital and health system executives polled would not have a chief executive lined up if their CEO suddenly left, according to a new survey.

Fifty-four percent of 164 executives surveyed said they don’t have a ready successor and 43% operate without an effective internal succession plan,

What do you think they should do? I mean it won’t be easy finding people to pay millions a year in salary.

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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] 

  5 comments for “Hospital Employment Crisis

  1. Aaron M. Levine
    February 6, 2019 at 11:57 am

    The case studies of corporation studies during my MBA showed that the most successful leaders groomed their successors rather than leaving it to chance. Look what just happened in Canada with the $200 million Bit coin fiasco with the death of the CEO.

    The Memorial Hermann system replaced its CEO with a Dr. Chu who had been part of the NY Health System and I think Kaiser. No one really knows what happened. He lasted a few months and quit abruptly. A suit replaced him.

  2. Anon
    February 6, 2019 at 9:57 am

    This is timely — our CEO Jon Pryor, MD at Hennepin Healthcare, Minneapolis, Minnesota, just announced he’s resigning. Announcement was Tuesday (Feb 5), resignation effective Thursday (Feb 7). Succession plan TBD.
    My take (which is only my own) is that he did a decent job with a crummy set of inputs: a safety-net hospital whose pt cohort has a high illness burden, but also w/ a lousy payer mix. It’s a money-losing proposition any way you dice it because we’re a gov’t entity (county hospital) and beholden to our county board for our financial existence. Recently there’s been a crisis of confidence in the CEO re: community perceptions about ethics and informed consent in an EM/EMS study of ketamine for acute agitation in the field.

    Following up w/ the above comment, “physicians should take over these positions” —
    A few years back, our (at least nominally independent) physician group Hennepin Faculty Associates was more or less forced to merge with the hospital. One of the terms of the merger would be that the CEO will be a physician. Previous CEO Arthur Gonzalez, (MBA, not medical) didn’t get on particularly well with the medical staff, and since got himself in hot water in his next job at Denver Health due to cost overruns with his EHR installation — just shy of $200 million. However, I think MD as CEO is no guaranty of medical staff happiness. Dr Doug’s frequent references to what can only be called “industrialized medicine” are spot on. The landscape is that medicine is run as a corporate enterprise, out of necessity. Good luck opening a mom-and-pop hospital these days, given the regulatory landscape. We need ever-larger legions of administrators, compliance officers, lawyers, coordinators, to avoid running afoul of JCAHO, CMS, ACGME, and the rest of the alphabet soup.

  3. Steve O'
    February 5, 2019 at 8:07 am

    True, and swell idea, Susan, but the whole thrust of American medicine since about 1980 was to jam it into a Corporate Retail & Industrial model. Before that, hospitals were small community entities, run by communities for communities. Heretical nowadays, no?

    America is in the throes of the familiar and historical cycle, the twilight, of culture and civilizations. The Maya went through it, the Easter Islanders – cultures blow out like a bad tire and fizzle. The Dark Ages in Europe came after the twilight of Rome.

    Frequently, there is a priestly caste which arises in many successful societies, which promulgates nonsense in various forms, that becomes rigid dogma. The caste becomes very comfortable with its position of power, so it continues to churn out endorsement of thoroughly bad ideas that make up the identity and strength of their main message, this ideological hucksterism. The USSR’s Communist Party was a swell example of ideological hucksterism with benefits.

    In the USA, there are plenty of superstitions around the Corporate Retail & Industrial model which are followed as Gospel, even though they have proven a bust in many circumstances over and over again.

    One is BIGIFY MEANS BETTERIZATION! so we have a playing field tilted towards the mega-corporate structure. Another is that management in one field is identical to management in another; that is why hospitals “need” health system executives, who are fluent in management speak, which is the universal language of command in all industries. You can think of a half-dozen more cultic beliefs disguised as managerial beliefs, go on.

    Politically, Democrats support megacorporations under the heavy hand of government regulation, called a government health plan, and Republicans support megacorporations under the heavy hand of government regulations, called privatization. There is no other path.

    To allow healthcare to be offered for the purpose in which it exists, from which it naturally arises: as a rational specialization of human action intended to mitigate human suffering, arising and belonging within the towns and cities who understand their own needs and craft their own solutions, is now heresy, counterrevolutionary, in the industrial cult of modern America.

    Usually, the priestly class rides the dying civilization down in flames until it crashes into a dark age, rather than embrace rational change in that civilization. It does not see its own beliefs as toxic and irrational burdens on the society. Rather, it believes fervently in its own nonsense – that the priestly class understands Ultimate Truth. The priests prefer Armageddon to self-doubt. And in medicine, the hospital administrators and CEO’s of insurance companies and the deputy senior assistants in HHS, are the New Priests.
    Sorry, but rationality won’t come back until the collapse, I fear.

  4. Susan
    February 5, 2019 at 7:22 am

    Physicians should take over these positions. Before World War Two physicians and nurses ran the hospitals.
    Those who had clinical careers and were older and transitioning to less physically active clinical work would take on these roles. Let us do this again!

    • Aaron M. Levine
      February 6, 2019 at 12:00 pm

      I remember 50 years ago when there was a physician shortage. Many hospitals had MDs (and I presume DOs) as the CEO. The emphasis was to retrain these physicians into medical practice and allow the business people to operate the hospitals more efficiently.

      I do not know the current status, but when I was on Active Duty 40 years ago, the head of the army hospital was an MD and he had an assistant (Medical Service Officer). I don’t know what is the current situation

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