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Why are our jobs so difficult?

Why are our jobs so difficult?

"If you can manage health care, you can manage anything,' I was told in my first interview for a laboratory management position. It took me some time to realize how true those words are. Management jobs at all levels in health care seem to be more complex than comparable positions outside the field. Just consider the following differences between health care and other industries:

Product mix. Managers at McDonald's have at most 20 or 30 products to be concerned about. Due to standardization, they know not only the number of hamburgers sold but also the cost of producing each one. Most laboratories, on the other hand, have a product mix of 200 to 300 test procedures, each with separate ingredients and production costs. It is very difficult to determine our most profitable products and our losers. Even when we can, we have little control over which products to offer since we must supply all of them to our clients.

Decision making. One major difference observed by managers who come over from other industries is how long it takes to reach decisions in health care. In addition, the decisions are not always made objectively. Nothing is more frustrating for a manager than having a fact-based proposal denied because of organizational politics.

Leadership. I like to break leadership into two categories: individual and industrial, the latter referring to companies or organizations that show the way for others to follow. Most businesses operate under a single chief executive officer or president serving as an individual leader. Hospitals, however, usually have a two-tier medical staff/administrative hierarchy. This dual leadership is often unfocused, sending out mixed signals and conflicting direction to managers and supervisors.

From an industry standpoint, health care lacks trend-setting organizations akin to IBM and General Motors. As a result, most providers fend for themselves, each tending to reinvent the wheel to make improvements in health care delivery.

Planning. Long-range planning is a tedious process in any business. It is even more so in a field such as ours where so many variables lie beyond our control. When we develop long-range plans, we must take into account such outside forces as health care funding, legislation, alternative methods of health care delivery, changing technology, etc.

Expectation of perfection. The constant expectation of perfection places an extra burden on laboratory managers. Detroit would be thrilled with a system that produces only one defective car out of 100. In fact, just about any business would be happy with a 99 per cent accuracy rate in production or services.

Our profession, however, deems even a 1 per cent error rate unacceptable. My own laboratory, for example, processes approximately 1.8 million procedures a year. Settling for a 99 per cent accuracy rate would mean that we'd send out 18,000 erroneous resuits a year.

Will managers' jobs in health care become easier in the future? I doubt it. Unless we experience sudden and drastic changes in the way hospitals are operated, reimbursed, and make decisions, I do not foresee any significant improvement. We can only hope that things won't get any worse.

The best way to prevent our jobs from becoming even more difficult is to become better informed. We need to keep an eye on the horizon--not only for industry trends and legislative issues but also for those changing forces in our own organizations that may affect our positions. A well informed manager is an effective manager.

Even if our jobs do not become easier in the future, we can take solace in the fact that working under such difficult circumstances is turning us into some of the best supervisors and managers in any industry.
COPYRIGHT 1986 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1986 Gale, Cengage Learning. All rights reserved.

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Title Annotation:managing medical laboratories
Author:Marateam James M.
Publication:Medical Laboratory Observer
Date:Nov 1, 1986
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