A Hip­po­cratic oath for health­care man­agers

Modern Healthcare - - COMMENT - By Peter But­ler Peter But­ler is pres­i­dent and chief op­er­at­ing of­fi­cer of Rush Univer­sity Med­i­cal Cen­ter, Chicago.

Most health­care man­agers I know de­scribe their ca­reer choice as a call­ing. We did not pur­sue ca­reer pro­gres­sion for its own sake; we wanted to make a mean­ing­ful dif­fer­ence.

Many of us were taught in grad­u­ate schools with ac­cred­ited health­care man­age­ment pro­grams. These pro­grams rec­og­nized a core body of knowl­edge and lead­er­ship com­pe­ten­cies that de­fine health­care man­age­ment as a pro­fes­sion unto it­self. Some of us re­main highly in­volved with pre­par­ing fu­ture health­care man­agers, through con­nec­tions to grad­u­ate ed­u­ca­tion and or­ga­ni­za­tional lead­er­ship acad­e­mies.

At a time when the coun­try needs strong health­care lead­er­ship, the prac­tice com­mu­nity needs to en­gage with the higher ed­u­ca­tional com­mu­nity we are trust­ing to pre­pare our fu­ture lead­ers. Whether it’s the Pa­tient Pro­tec­tion and Af­ford­able Care Act (which seems to get blamed or cred­ited for vir­tu­ally ev­ery­thing to­day), emerg­ing pay­ment mod­els, or con­sumer-driven ex­pec­ta­tions, change is oc­cur­ring faster than higher ed­u­ca­tion can keep up with on its own.

We need to col­lab­o­ra­tively re­visit the com­pe­ten­cies at the foun­da­tion of our pro­fes­sion and rou­tinely eval­u­ate them as health­care continues to evolve. If we let our roles be de­fined by what the fi­nan­cial mar­kets and rat­ing agencies still in­cen­tivize—growth, mar­ket power and strong bal­ance sheets—we will find it in­creas­ingly dif­fi­cult to ar­gue that health­care man­age­ment de­serves the same pro­fes­sional stature as that of our clin­i­cal coun­ter­parts.

But if we broaden our fo­cus—to in­clude in­creas­ing ac­cess for all and meet­ing the triple aim of lower per capita costs, higher qual­ity and bet­ter health—we will have unique and im­por­tant con­tri­bu­tions to make.

Per­haps it is time we pur­sued a Hip- po­cratic oath for our own pro­fes­sion. Such an oath should help us re­mem­ber that what hap­pens out­side our or­ga­ni­za­tions is as im­por­tant as what hap­pens in­side. It should help us pause to rec­og­nize that the en­emy is not the com­pe­ti­tion; it is ill­ness and dis­ease. And it should help us stay fo­cused on the higher pur­pose we chose when we en­tered health­care ad­min­is­tra­tion.

Ar­tic­u­lat­ing a new vi­sion and new com­pe­ten­cies won’t be easy, but the larger goals that we share with the pub­lic must be em­bed­ded in our pro­fes­sion, from our ed­u­ca­tional pro­grams to the pay­ment sys­tems we sup­port and re­spond to. Any­thing less and our pro­fes­sion risks los­ing the moral com­pass it needs to move pol­icy and per­for­mance in the di­rec­tion we all know is needed and pos­si­ble.

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