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IS THIS THE PARTY TO WHOM I AM SPEAKING?
Mary G. Barry, MD
I
Louisville Medicine Editor
[email protected]
hear Lily Tomlin in my head whenever
I am subjected, as are all employed physicians, to the spume of corporate admonishments. Often it is merely annoying,
but generally the dull barrage of verbiage
from the Head Office is simply a front for,
“We sort of deign to talk to you, but not
really.”
Recently we have endured the four -hour
safety testing and annual corporate compliance time-wasters. Currently we are disputing recent mandates to have full office
hours on Christmas Eve and Oaks Day,
having just fought a battle about the day
after Thanksgiving. The main billing office is
hungrier than ever for new code-able visits.
Apparently, family togetherness and beloved
holiday traditions matter far less in management world than big budgets, big debts, and
big plans to buy every hospital on the shelf.
Of course, the NGoodHealth folks spout a
smokescreen of advice on “improving work/
life balance” on our annual Health Assessment forms. Despite the fact that fulfilling
the NGoodHealth edicts does earn employees a financial credit for health insurance,
it’s all just lip service. At the grunt level we
who do all the patient care are being held
upside down to shake the hours from our
pockets. But in business-speak it is “maximizing productivity” instead of “We buy,
you pay.” And from what I hear from my
compatriots at some of the other hospital
brands in this city, things are exactly the
same there too.
Some sort of brainwashing must go on
in MBA programs. People go in speaking
English and come out speaking Camouflage. The USMC (who look good in camo)
like all branches of the military, speaks in
acronyms. They say “RIP/TOA” and mean
“Relief in Place/Transfer of Authority” when
one unit relieves another at a duty post. But
they also say, “KIA, ” leaving no bones about
it. However, management types, faced with
a fatal wound to a budget, manage to kill
off lots of jobs without ever using the word
“fired.” Witness this statement from Mr. Bob
Graziano, the head of Ford in Australia:
To better position the company to compete
in a highly fragmented and competitive
market, Ford will cease local manufacturing in October 2016. All entitlements are
protected for the 1200 employees whose
jobs are affected, and the company will
work through the next three years to provide support.
I suppose he could have said “downsizing”
or “rightsizing” or “detransitioning,” other
euphemisms for You’re Fired. “Affected” is
so sterile a term, removing any hint of the
violent blow of losing one’s livelihood. He
does not say, “We’ve decided to dispense
with your job instead of mine,” or “Our decisions to date have maybe been disastrous.”
Instead, he explains:
Ford is transforming its Australian business by accelerating the introduction of
new products for Australian customers,
enhancing the sales and service experience,
and improving its business efficiency and
profitability.
This is perfect Camo-speak – a paragraph
of a sentence that yields zero facts or meaning. Imagine the junior medical student presenting her jaundiced, septic, hypotensive,
anuric patient to her boss in Camo-speak:
“He is, at the end of the day, not going forward or optimizing his core competencies.
To drill down, he has issues with key metrics and is not leveraging his throughput.
Current projections are for sunsetting – he
might be taking this offline.”
So far as “brand alignment initiatives,
“what some hospital outfits in this city have
done this fall is to rip big holes in doctorpatient relationships by holding employees’
wallets hostage for keeping a doctor not “in
network.” All of the independent doctors
whose specialties are represented inside a
hospital’s network will face financial competition from the employed physicians in
those specialties, to a greater or lesser degree
depending on the system. The same sorts
of office visits and procedures “kept in” the
Norton system for a Norton employee will
cost patients a smaller copay than if that
employee chooses a non-Norton specialist.
But “crossing Chestnut Street” can up the
ante for Norton employees. Especially for
those with the high-deductible plans, people
who choose doctors not Norton-owned face
additional costs going up into the thousands
(continued on page 36)
January 2014
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