The Ultimate Healthcare Employee

What exactly is the best qualities in a healthcare employee? Is tact, compassion, competence, high work ethic, or diligence the most important? In many ways these qualities tend to boil down to three aspects (not in order of importance): 1. Passion for their profession, 2. The ability to use intelligence in an efficient and effective manner, and 3. The ability to work together.

One of the most important qualities for any potential candidate is not only the ability to work well and cooperate, but also have the desire to do so. Cooperation is the benchmark of any well organized, efficient, and effective healthcare organization as many departments tend to overlap and are heavily dependent on one another. This quality has become so important that many hiring managers have begun to examine beyond the professional and academic qualities of an individual to see if they can become part of the "team" (Bowen et al, 1991). The ability to cooperate and act in a professional manner at all times, while seemingly a simple request, can have a significant effect on the overall efficiency, clinical efficacy, and financial stability of the organization. In summary, the faster the work is processed the more inexpensive the product becomes.

While the ability to cooperate can be look upon as the foundation of any "team", it is also important that each member of the team be well informed, well educated, and continually updated on any pertinent information. Generally, this does not mean that the individual has the potential to be intelligent, but rather that they have the continued ability to gain further knowledge and insight into new techniques, tools, etc. in the ever changing healthcare field (Ganzach, 1998). The ability to have new information and in turn apply it in an effective and efficient manner can not only improve the overall quality of the organization, but also have significant impact on improving employee moral.

Finally, a healthcare employee must have a passion for their work. The healthcare industry is similar in many ways to other industries, but is also incredibly different at the same time. The reason behind this is simple: every action each employee takes directly or indirectly affect the livelihood of an individual. It is critical that each employee or potential employee have the desire to work as many hours as possible, work as hard as possible, or learn as much as possible to help improve the lives of others around them. In the end, while organizations must remain financially solvent it is even more critical that they also remain passionately solvent.


References:

Bowen, D., Ledford, G., Nathan, B. (1991). Hiring for the Organization, Not the Job. The Executive, 5(4), pp. 35-51.

Ganzach, Y. (1998). Intelligence and Job Satisfaction. The Academy of Management Journal, 41(5), pp. 526-539.

"I Perform Surgery Better when I've had a Few!": and Other Phrases You should never Hear from a Surgeon.

I have often find myself wondering what exactly would posses an individual from becoming a physician. The only one that I know by name is my father, there are no physician trading cards, and for the most part each of them are not "rolling in dough". I have often found myself asking friends or peers who are in medical school or planning to attend medical school why they would put themselves through such torture? Not surprisingly many give the same answer: "because it is the ultimate sacrifice I can make to help my fellow man". With such a valiant belief it's not hard to see why so many within our society respect and admire physicians.

While I will be the first in line to congratulate and thank any physician for making this sacrifice the reality is simple: they are still people. This means they are going to make mistakes, act rude, say weird things, or even wear weird clothing. Some physicians are pretty normal, some are eccentric, some are boring, and some are very interesting. However, when they day begins they "put their pants on one leg at a time" like everyone else. This means that while a talented physician may be desired by many different healthcare organizations, they still must be willing or at least able to adhere to the culture of the organization they are joining (Valentine, Godkin, and Lucero, 2002). This means that while they are highly valued, they must be disciplined in the same manner as anyone else.

Recently, I have encountered a case study where a respected doctor fails to keep to his commitment as the on call surgeon and shows up intoxicated to surgery. This, in my opinion, is unacceptable for a variety of reasons. First and foremost, doctors are people and this surgeon could have easily "called in sick" allowing the facility to call another surgeon to replace him. Secondly, the surgeon has gone directly against the Hippocratic Oath by putting himself, others, and the patient due to his drunk driving and possible treatment of the patient while impaired. At the end of the case study the text asks simply: what would you do? The answer is simple: release him immediately. It's one thing to make a mistake, but to act so bold is simply unacceptable. No one individual is greater than the organization and a doctor, by this point, should realize that.

References:

Valentine, S., Godkin, L., and Lucero, M. (2002). Ethical Context, Organizational Commitment, and Person-Organization Fit. Journal of Business Ethics, 41(4), pp. 349-360.

The Unsteady Hand of the Stark Act

From its inception in 1989 Stark (the Act), officially known as the Federal Physician Self-referral Law, has allowed an "ethical background" from which healthcare organization can build and maintain their own ethical regulations and protocols. In many ways, the Act has improved the quality of care available much in the way that antitrust laws have improved quality in the private business sector through the creation of competition. However, the Act is not without its own faults. For example, the Act basically covers Medicare issues in reference to financial relationships between physicians - their immediate family members - and the facilities which they refer Medicare patients (Gosfield, 2009).

This seems simple enough to understand, but many consider the Act to be outdated, very difficult to interpret, and follow (Sutton, 2011). Though the Act is written in very narrow and defined terms, difficulty is created due to its constant evolution and change. For this reason, many organizations have continued to create and apply their own version of the Act within their own organization. This has resulted in a general across the board "bench line" for each of employee of not accepting any freebies or kickbacks whatsoever from any vendor while under the employment of said employer. Sometimes even writing about the Act can be a bit of a mind twister!

This confusion has also led many to believe that the Act is also detrimental in many ways to the business of healthcare. As previously cited, the fear of violating the Act and as a result losing funding through Medicare and other government sources has created a tremendous fear amongst facilities. This, in turn, has created a very regimented business atmosphere that has significantly hurts a healthcare facility's ability to grow (Taylor, 1999).

Though the healthcare industry is not a business in the same sense as companies like Apple or Nike, it is still critical to remain as financially stable as possible. The Act like many other government regulations imposed on the healthcare industry has created a virtual mine field that organizations and administrators must navigate on a constant basis. Ethically, the Act has created a culture that strives to continually evolve ethically, but it should not stand in the way of creation, evolution, and ingenuity. If so, the healthcare industry at best will not perform to its abilities or at worst continually regress.

References:
Gosfield, A. (2009). Stark Law Covers a Narrow Corridor of Actions (Malpractice Consult). Medical Economics, 86(17), 38.

Sutton, P. (2011). The Stark Law in Retrospect. Annals of Health Law/Loyola University Chicago, School of Law, Institute for Health Law, 20(1), 15.

Taylor, M. (1999). Healthcare Struggles with Stark Reality. Modern Healthcare, 29(27), 30.

Ethical Tools for All

What exactly is the Healthcare Industry? Who works in the healthcare industry? Does it only constitute doctors, nurses, allied healthcare staff, hospitals, clinics, and the first aid station? For many, the healthcare industry is composed of the staff and facilities that provide direct patient care. However, those who support the healthcare industry have begun to be included, in the author's opinion, in this most important of all social clubs. For example, the individual billing clerk may not provide direct patient care, but their ability to properly (and ethically) code and bill insurance companies can have massive influence when compounded. Multiply their actions by as many billing clerks currently employed today, it is easy to see how billions of dollars and as an effect the quality of healthcare delivery can be seriously augmented by support staff.

While significant cost concerns support staff can create or alleviate is of vital importance to any healthcare facility, what can be said about the human cost? To an extent, support staff can create an environment conducive to increasing the quality of healthcare delivery while maintaining costs. Though nurses are very much considered an integral part of the "staff" of any hospital or related facility, they were considered for many years "support staff" to the all-mighty physician. As a result, more and more studies where conducted to see what affect, if any, nurses had on the health of the patient and finances. The result was not only the elevation of nurses to the level of physicians, but also the need for specialized nurses (Czaplinski, 1998).

With the obvious need for highly trained support staff continues to increase, have we done enough to also give these individuals the tools to act as professionals? Though the level of education is not indicative of one's level of professionalism, it is easy to assume that similar individuals may simply not understand or posses the knowledge to understand the intricacies of what makes a healthcare professional. More specifically, the need to understand and follow the highest ethical standards. Though high ethical standards within traditional healthcare facilities (like hospitals) have become the norm for all staff, many "support staff" operating in non-traditional facilities do not received the same amount (if any) of ethical training required of healthcare professionals. Though we expect support staff to function at the level of any healthcare professional, why do we not provide them with the same tools and expectations?

References:
Czaplinski, C. , et al. (1998). The Effect of Staff Nursing on Length of Stay and Mortality. Medical Care. V36:12. pp. 1626-1638.