Tuesday, September 22, 2009

The Song Remains the Same

As we all know, health care is extremely challenging and rewarding. Health systems and physicians are constantly challenged with building a practice and ultimately developing a succession plan to serve their communities and continue to meet its health needs. Let me share some excerpts from a St. Joseph Hospital Medical Staff Analysis:

Conclusions and Recommendations:

The present medical staff was analyzed on the basis of available historical information.
While projections are subject to a certain amount of error, it is clear that projected admissions per year are far below the estimated need. Analysis indicates that while some physicians will increase their practice, a number of physicians will probably decrease their practice and in many cases the decrease will be substantial.


The age distribution of the present staff, while not unusual at the present time indicates a problem within the next five to ten years. Replacement of Medical Staff to compensate for retirement in the future should be an ongoing concern.

The fact that 10% of the staff provides 58% of patient admissions could be a problem. The unexpected loss of two or three doctors could result in severe economic repercussions for the institution. Similarly, the sudden shift by a doctor of his patient admissions from St. Joseph to another hospital, for whatever reason, poses a problem to the institution if the concentration of patient admissions in a few doctors is significant. This analysis indicates a need for quick and decisive action to recruit sufficient medical staff to provide even a minimum acceptable occupancy level in the facility.

This analysis was written in December 1975; I thought you might enjoy!

In 1990, a similar analysis was performed with similar conclusions. On the final page of that report was a graphic showing the Hospital Board, Medical Staff and Management on the three points of a triangle, all pointing to a central goal-The Patient.

Our challenges were the same in 1975 and 1990 as they are today and, more importantly, our mission and values were the same in 1975 and 1990 as they are today. Indeed, these values have not changed since the Sisters of St. Joseph of Carondelet founded St. Joseph Medical Center in 1874.

One thing is for sure, while the challenges are similar throughout the years, it still feels, at any given time, that today's are the biggest challenges of our lifetime. Nevertheless, we continue to honor our commitment to our patients, our physicians and staff.

Janet S., a person I worked with early in my career, let me know that it would be like the movie Groundhog Day throughout my career. She told me not to throw away any projects because they always seem to come back into the picture every few years--I could just "dust them off" and revisit the assumptions.

I look forward to hearing some of your classic stories and lessons from years past.

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