Cohn Kenneth H, Gill Sandra L, Schwartz Richard W
Cambridge Management Group, 625 Mount Auburn Avenue, Cambridge, MA 02138, USA.
Surgery. 2005 Feb;137(2):132-40. doi: 10.1016/j.surg.2004.09.006.
Despite marked differences in training and professional interests, physicians and hospital managers face similar problems stemming from the unprecedented rate of change in the health care delivery system: failure of reimbursement to keep pace with rising costs, new therapeutic modalities, increasing government and managed care regulations, heightened consumerism, and an aging patient population. In the face of these mounting challenges, both physicians and hospital managers could benefit significantly from a climate of collaboration and interdependence.
This article presents a "case report" of a community teaching hospital in which practicing physicians and hospital administrators collaborated to develop an operating plan for the next 3 years to improve the practice environment.
The physicians recommended new clinical priorities to enhance service to patients and families, to improve physician-physician communication, to develop clinical protocols, and to build coordinated diagnostic treatment centers, which the administration has implemented.
Physicians and hospital managers can no longer pass on cost increases at will to patients and third-party payers. Nor can physicians and managers ignore the heightened power of patients and third-party payers. Effective dialogue and collaboration are in all parties' interests to optimize patient care and to develop innovative services. Despite the tensions created by competition and rapid change, transformation from a blaming to a learning environment may be a key strategic advantage in today's health care marketplace.
尽管医生和医院管理人员在培训和专业兴趣方面存在显著差异，但由于医疗保健服务体系前所未有的变革速度，他们面临着类似的问题：报销未能跟上成本上升的步伐、新的治疗方式、政府和管理式医疗法规不断增加、消费主义抬头以及患者群体老龄化。面对这些日益严峻的挑战，医生和医院管理人员都能从合作与相互依存的氛围中受益匪浅。
本文介绍了一家社区教学医院的“案例报告”，其中执业医生和医院管理人员合作制定了未来三年的运营计划，以改善执业环境。
医生们提出了新的临床重点，以加强对患者及其家属的服务、改善医生之间的沟通、制定临床方案以及建立协调的诊断治疗中心，管理层已予以实施。
医生和医院管理人员不能再随意将成本增加转嫁给患者和第三方支付者。医生和管理人员也不能忽视患者和第三方支付者日益增强的权力。有效的对话与合作符合各方利益，有助于优化患者护理并开发创新服务。尽管竞争和快速变革会引发紧张关系，但从指责型环境转变为学习型环境可能是当今医疗保健市场的一项关键战略优势。
