Healthcare Executives – The Hidden Power in Hospitals

PauletteKranjac2013PhotoWhen I think of a busy medical center, the image which comes to mind is not usually a hospital that is filled with healthcare executives looking to make purchases for supplies of all types, nor of health service administrators needing to enlist a wide variety of services.  The image that comes up is usually the set from a hospital TV show, embedded in my memory as a place servicing patients with life and death matters. This includes shows like: Trapper John where my friend from grade school, Christopher Norris played Nurse Gloria Brancusi,  Doogie Houser, MD which inspired us with the young and amazing Neil Patrick Harris, and ER with the incredible team of Julianna Margulies and George Clooney, and with great writing/producing by my husbands’ talented medical student colleague, Lance Gentile, MD.

What does not come to mind is that there are over 100 different high level administrative job functions within hospitals in the United States.  From clinical coordinator jobs for the department of neurological surgery and department of orthopedic surgery, neonatal care director, infection prevention director, burn care unit director, hospice head– to the laboratory director, hospital pharmacy director, quality assurance director, medical records director and purchasing director, senior hospital personnel  positions/healthcare executives are running huge and diversified businesses all within one institution. Such executives may need everything as simple as vending machines, personnel agency assistance, forms, IT and office equipment to highly technical and specific medical equipment.  And though purchasing needs of healthcare executives are very varied in nature, they sport several common threads.

Every specialty department has an office, a waiting room and a substantial budget to buy appropriate products and services. Each of over 100 departments of 7,000 hospitals is run as a budget-rich, semi-independent entity, yet each is individual. Therefore for general categories of products and services representative of running an office, each department is a potential customer.  ACHE[i] (surveying over 1000 community hospitals with 36% responding) found interests and concerns of hospitals including:  72% of respondents indicated a challenge was to reduce operating costs, 71% wanted to engage physicians in improving the culture of quality, 67% wanted to eliminate bad debt, 66% felt redesigning care processes was key and 45% felt redesigning the work environment to reduce errors was important. Solutions for addressing these needs could go a long way in supporting some of the issues in hospitals now.

There are about 200,000 administrative jobs within these 7,000 U.S. hospitals (about 75% of which are privately funded).  Types of hospitals range from general medical and surgical facilities as the great majority, to psychiatric, long term acute care, rehabilitation and children’s’ eye, ear, nose and throat institutions. There are 25 additional types of service hospitals with fewer hospitals within each type.  For each of the 100 healthcare executive specialty areas within specific departments, there is an ability to reach health service administrators with esoteric and specific products and service items germane to their needs and interests solely.

The field of medical and health service management is growing at a brisk pace of 23%[ii] with the number of directly addressable staff in hospitals at over 200,000 [iii]. Though a patient-centric model of care is ideal, shifts with regard to financial cuts and economic realities as well as ubiquitous healthcare information reaching patients, has turned healthcare practices increasingly business-focused as an industry[iv] and highlights the importance of balancing the interests and needs of the of the patient while making sound business decisions for the institution.

[i] American College of Healthcare Executives, Research and Resources, Top Issues Confronting Hospitals, 2013

[ii] Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook2014-15 Edition, Medical and Health Services Managers

[iii] LPD Managed Mailing List, Hospital Personnel with Budgets, 2014

[iv] Phoenix Forward, Jill Elaine Hughes, March 7, 2012

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