Scatter my ashes here...

Scatter my ashes here...
scatter my ashes in the desert...

Tuesday, May 7, 2019

Ode to the Zombies in the C-Suite

CEO pay is a problem. The administrative costs of running healthcare have increased because we’ve added so many layers of complexity and bureaucracy that have nothing to do with healthcare or outcomes.

The hospital and insurance industries are fighting against Medicare for all or any largely single payer system. They have stolen the money from the people who need healthcare. They use this loot to harness the power of lobbyists to write and promote legislation to keep their advantages and privileges away from the masses who might benefit from being able to afford medicine to stay alive.

How do they make so damn much money? They cut costs like crazy, and big costs like staffing are the first on the chopping block. CEOs are not considered healthcare staff. They don't contribute to health, or care. In fact, they operate against it. You don't need a heart, and certainly don't need empathy, to run a healthcare facility. All you need are pure, driven, focused, sociopathic tendencies. Just be a Zombie, and you'd make a perfect CEO.

On Nurses’ Week, let’s also remember the other people who do work in healthcare, including non-clinical workers. Understaffing is a widespread and dangerous practice, whether you work in direct patient care, take out the trash, provide security, or transport patients around the hospital. None of us can do our jobs without the others.

You cannot run a hospital without keeping it clean. You cannot run a hospital without people to move patients from one room to another or from their room to a procedure, changing lightbulbs, sterilizing equipment for surgeries, emptying sharps containers, and all the other things that are taken for granted but are crucial to safe and complete operation of a hospital. You can’t short staff the people who maintain the medical equipment or stock the supply shelves. You can’t short staff security, because there are actual and potentially violent individuals who enter the hospital.

You can’t even have short staffing for human resources, if you need to keep hiring people all the time due to your high turnover. Of course, you can try underpaying everyone, and in a low unemployment market, you can blame your inability to attract new employees on flaws of the existing staff. It certainly couldn't be the fault of anyone higher up.

By relying on as few staff as possible, you end up burning out the existing employees, who have to run at a faster pace, are more likely to miss details or make mistakes, or have to cut corners in order to get all of the work done in the time they are allotted. They can’t go on vacation because there’s no one to take their place. Doesn’t matter how much vacation time they’ve accrued, they can’t use it. And the shorter staffed they become, the more stressed the workers become, from the bottom up through consecutive layers of management.

Until you reach the C-suite- where they are somehow insulated- they can avoid and escape the chaotic and stressful everyday environment. And even if their worst stressors materialize- low patient satisfaction scores (gasp!)- they can apply pressure downward and no harm will come to them in their suits- they rack up bonuses and extra perks, and even if they are fired, they have a golden parachute coming, to keep them wealthy as they navigate the revolving door of the close-knit executive world.

Yet this is the model on which the executives expect the hospital to run. The mega-corporate near-monopolies have limited competition, driven prices up, and contributed to our plummeting outcomes and skyrocketing costs compared to every other industrialized country.

Blinded by data, the Suited Scourge wanders through the back hallways away from patient rooms, haunting management with blood-drenched HCAHPS printouts. Wide eyes bulging and bleeding from their sockets, insisting on hearing the magic “yes” to every demand. Keep downstaffing and don't stop until there is just one employee covering each floor, responsible for every patient, dust bunny, and soiled washcloth 24/7. Get those products patients in and out fast, to maximize revenue. Crank up the speed on the assembly line, the robots staff will have no choice but to keep up. If the products patients live long enough to beat up the robots staff, sue 'em for property damage to reduce the replacement cost.

Then, and only then, will the Zombies be satisfied, as long as the patient satisfaction surveys come back in the 90th percentile, and dripping with blood.

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