I have read with interest several recent posts, at Kevin, MD, retired doc’s thoughts, Health Care Renewal and other docblogs, alluding to the pernicious influence of “suits” on American medicine. Being a card-carrying suit myself, I thought the following true story might illustrate why this much-despised breed exists:
I once worked for a well-run, not-for-profit hospital whose net income was consistently healthy enough to keep us up to date on the technology and capital improvements required to provide quality care to our patients. The patients, physicians, and staff were happy and the hospital was a valuable community resource.
After I had been there for several years, there was a regime change on the County Hospital Authority that oversees such institutions, and the new brooms decided to “improve” the operation of the hospital by firing the “suit” whose leadership had put us in such good shape. They replaced him with a physician.
It soon became obvious that our new CEO had nothing but disdain for “suits.” He was utterly incapable of believing that we might actually be in possession of knowledge that had eluded him. Thus, our attempts to make him understand certain aspects of health care finance and hospital operations fell on deaf ears.
Before long, it also became clear that many of the decisions our Physician/CEO was making (against the advice of the lowly suits) would do serious financial harm to the hospital. At length, this situation became so frustrating that I and several other “suits” moved on to other organizations.
Within a year, I received a call from one of my former colleagues, who advised me that the good doctor had been fired and that the hospital was in financial ruins. The patients, physicians, and staff were now miserable and a once-prosperous community hospital had become ripe pickings for some for-profit chain.
Obviously, the moral of this tale isn’t that all “suits” are paragons (I have known plenty of boneheads in neckties), or that all physicians are hubristic know-it-alls. The point is that there is more to a health care delivery system than docs peering down inflamed patient gullets.
One doesn’t necessarily need to know how to deal with hallucinations or bloody vomit to make a useful contribution to health care.
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