What if hospital business models weren’t so tribal?

I tend to look at it from the perspective of the business model of many hospitals.  How does one transform a 0.2 business model to function in today’s let alone tomorrow’s changing healthcare model?

The clinical side of healthcare, the healthcare business, in juxtaposition to the business of healthcare, would never quarter to the idea of buying millions of dollars of technology without first knowing how they were going to use it.

Plenty can be gained by applying what other industries have done to become more effective.  In some respects the inherent structure, cost duplication, and rigid departmental silos remind me a lot of how the various agencies under Homeland Security function, operating in isolation, performing much of the same work, and not sharing information.

Other industries operate with a much less tribal model than healthcare.  Hospitals have created tribes and tribal chiefs.  In some hospitals the tribes have names like radiology, general surgery, psychiatry, and OBG/YN.  Other hospitals have redundant tribes named admissions, human resources, IT, and payroll.  Each tribe is run by the tribe’s chief.  The chief’s dominant weapon is his or her budget which is lorded over its individual tribe, and a dispute vehicle of the other tribes.

The tribal organization is more a reflection of how the hospital evolved over the years, not a result of an inept business strategy.  Nobody set out to build an ineffective and internally competitive model, or one that duplicated support functions.  Acquisitions have reinforced and exacerbated the problem, duplicating and increasing costs without yielding a resultant increase in value.

Before the business of healthcare is prepared to cope with the unknowns of the myriad of external influences it will face in the next few years, it must first change how it functions under its current structure.  It might begin by revisiting its present structure and making sure that its performance and quality precede the application of technology.

I frown on using the term efficient.  To me, efficiency implies speed, and doing bad things faster is no solution.  Let us work at improving effectiveness and good things will happen.


One thought on “What if hospital business models weren’t so tribal?

  1. Definitely agree with every word in this article. The system that hospitals use today is obviously one that works, but it does not mean that there isn’t room for some improvement or even great improvement. With a more effective system in place, millions and possibly billions of dollars could be saved in this area and that could go out to helping others in our country as opposed to being an unnecessary expense. Just like the simple guidelines and rules that all hospitals should follow to prevent malpractice and mistakes made during procedures on patients, everything should be as effective as it possibly can be and of course, without sacrificing quality for speed.

    I have a blog that discusses a profession that works in hospitals at http://www.surgicaltechsalary.org if you have some time take a look there is some great information there. Thanks 🙂


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