Cultural transition from a purely Corporate hospital ———-> corporate + teaching hospital
Catch 22 situation . Private hospital —> Private + Teaching hospital transition.
We are one of the big private sector (for profit) health organisation/corporate hospital . In the last 2 years there has been a lot of highest level (MIS-)management issues leading to the exit of the initial promotors / owners .Finally we have been bought out by a good healthcare chain based abroad but somewhat new to the style of functioning here.Hence you can imagine that a lot of discussions are going on about aligning the objectives of both the organisations in a profitable way.
As a policy ,our hospital has been advised to add academic services also for the training in various surgical specialities and super-specialities ( ?? primary purpose is the get a stable and regular supply of resident doctors and that also at a cheaper rate 🙂 )
At the outset ,it seems to be a very GOOD idea which will benefit the organisation in the long run. But few cultural changes are becoming difficult to convince to the employees. As per statutory regulations , the various Boards/Councils require a certain number of surgical cases to be logged in as assisted/operated under supervision/independently operated.
1.SURGEON’S POINT OF VIEW —Being a private corporate hospital, the Senior Consultants have their own private patients .They wont allow any juniors/residents to operate on them coz any misadventure might prove to be very costly for the SENIOR CONSULTANT’S reputation and obviously in litigation terms also.They stand a possibility of decrease in their surgical practice and diversion of patients to other surgeons based in competitor non teaching corporate hospitals.
2.PATIENT’S POINT OF VIEW—-Patients who come to these corporate hospitals are rich and affording and obviously demand the very best of surgical hands.They have negated the option of cheaper Govt training hospitals so as to ensure that only the best surgeons operate on them. If they have any doubt regarding being operated by someone who is under training, they might go to competitor hospitals thereby causing financial loss to our hospital.
3.ACADEMIC GRANTS —Separate financial grants are almost non existent or meagre as compared to the western world, so as to add any financial value to the hospital .The research and Teaching activities will have to be funded from the hospital earnings only.
4. RESIDENT’S POINT OF VIEW– If not given sufficient Hands-on cases, it will be injustice to their training responsibilities and the same will deter future residents from coming here for training.Plus there is a very high likelihood of them complaining to the Board/Council thereby endangering the status of the accreditation for teaching hospital status.
One solution is that we start admitting low socio-economic status patients or uninsured patients as “free patients ” or “Discounted patients” so as to help in hands-on supervised training of the residents. Due to shared infrastructure (coz our hospital was not built as a teaching hospital initially) we are not sure how our elite class patients will accept it. And it is also not certain how much financial overburden will have to be incorporated by the hospital
All suggestions that can address the concerns of all the stakeholders , are most welcomed.
Participant comments on Cultural transition from a purely Corporate hospital ———-> corporate + teaching hospital
Interesting questions. While I am not familiar with the various system cultural factors or overall structure, I took note of your comment about the hospital leadership being advised to add the academic/teaching services to build the “stable and regular supply of resident doctors” and ultimately lower costs. If those are the driving factors, it sounds like the need to expand beyond the wealthy client base to a broader spectrum of the population may be inevitable anyway? Are there structural mechanisms to have some type of VIP/concierge floor and limit the teaching hours for patients who may not be willing to choose those services?
It sounds like either way, leadership may need some consulting assistance on branding and strategic communications, in addition to whatever financial advice your team is receiving. It may be that the wealthy patients are more receptive to allowing (highly supervised) residents and trainees to participate in their care if they hear the big picture message upfront (“we are a teaching hospital so we make sure we have doctors when our kids and grandkids grow up”–or whatever is culturally and contextually appropriate in the situation).
Is there a generational shift possibility in the future as well–are younger “wealthy elite” patients perhaps more willing to allow for residents and others? I realize there are a host of regulatory, legal and business planning barriers that would have to be overcome in any of the design elements, but maybe something to keep in mind as you proceed. Good luck!