Thursday, February 12, 2009

Physicians' Unexpected Un-Helplessness: Executives Invited To Leave Nashville-Based Healthcare System

At "Physicians' Expected Helplessness" I wrote that:

I am going to coin a new term to describe what I have observed as a corollary to physicians' learned helplessness: "Physicians' Expected Helplessness."

I observed that "Physician's learned helplessness", an adverse effect of dysfunctional medical training and culture described here, had perhaps led to societal expectations of physicians being weak in defense of their profession and its patient-protective values, and "having a target pasted to their backs."

In a case of human bites dog - or perhaps, more to the point, doctors bite dogs - a physician revolt has led to the ouster of unpopular and apparently ineffectual executives including the CEO, COO and Chief of HR at a large healthcare system based in Nashville.

Two more executives leave Saint Thomas Health Services

By Getahn Ward

Two more executives have left Saint Thomas Health Services, continuing changes after physician leaders recently cast votes of no confidence in the management team.

The position of Bev Weber, chief operating officer for the Nashville-based four-hospital health system, was eliminated, spokeswoman Rebecca Climer confirmed late Wednesday. Angelle Rosata, chief human resources officer, also has left, Climer said.

Their departures follow last week's resignation of Chief Executive Jim Houser, less than two weeks after the no-confidence votes by medical staff leaders at three of the system's hospitals — Saint Thomas and Baptist in Nashville and Middle Tennessee Medical Center in Murfreesboro.

Doctors were concerned about a review of operations that they expected to include budget cuts and more centralized management of the hospitals. [Translation: even more mission hostile, autocratic leadership by non clinical bureaucrats -ed.]

Patrick Madden, who ran a Pensacola, Fla., hospital system for Saint Thomas Health's Catholic-run owner Ascension Health, began his role as interim CEO of the Nashville-based health system Tuesday.

"The elimination of the system-level COO position will allow for greater communication and interaction between the hospital chief executive officers and our new interim CEO and his leadership team," Climer said in a statement.

Weber, who joined Saint Thomas Health in May 2006, was an intermediary [and probable obstructionist - ed.] between Houser and CEOs of the system's hospitals. Doctors feared the hospitals would lose much of their authority under a proposed structure they believed was being considered as part of the review.

Weber was a target along with Houser of the no-confidence votes.

The COO position was actually eliminated due to the position serving as an apparent bottleneck between CEO and the medical staff.

It should be remembered - and made clear to "management" by physicians and other clinicians - that clinicians are the enablers of healthcare, whereas executives and near everyone else are facilitators of healthcare.

As such, when push comes to shove the physicians "own" the hospital (and could in an emergency provide a lot of services even if the hospital burned to the ground). However, they only can protect their own interests if they stand up for themselves and for medicine's core values. That also means abandoning quaint notions of "political correctness" and "inclusiveness" as the sole means of interacting with those who do not share those values.

This is a phenomenon that hopefully may set an example for other medical staffs beleaguered with mission-hostile management.

-- SS

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