Ask:
“If God really cares about cruelty to animals, how come he made foie gras taste so delicious?”

Once upon a time, hospitals were run primarily by physicians, but there’s been a real turnaround, and today MDs head just 235 of the nation’s nearly 6,500 hospitals.

The rest of the institutions are led by business-trained administrators — even though physician-led hospitals outscore all others by 25% in standard quality measures, according to a study in the June 25, 2011 issue of Social Science & Medicine.

What the results tell me: It may be time to turn back the clock, given the improved outcomes of doctor-run hospitals.

IS THERE A DOCTOR IN THE HOUSE?

The background: At the Institute for the Study of Labor in Bonn, Germany, investigators constructed a database of the top 100 US medical centers for cancer care, digestive disorders and heart surgery based on 2009 US News and World Report hospital rankings.

These rankings, designed to help consumers determine where to seek the best care, focused on:

Structure: How many nurses a hospital has, availability of key technologies, presence of a trauma center, etc.

Process: The delivery of care, which encompasses diagnosis, treatment, prevention, patient education and length of stay.

Outcomes: How many people die within 30 days of discharge.

Patient safety: How many accidental adverse events occur and how up-to-date medical procedures are.

Next, the researchers collected data on each hospital chief executive officer (CEO). They placed CEOs in one of two categories –

physician or nonphysician. Analyzing the association between doctor-run and administrator-run hospitals, the team found that:

Overall, hospital quality scores were 25% to more than 30% higher when a doctor was at the helm. For instance, when it came to cancer care, physician-led hospitals outperformed others by 33%.

In the US News “honor roll” of highest ranking hospitals, 16 out of 21 CEOs were MDs.

Of course, it should not be such a surprise that doctors are more effective at leading medical institutions.

Physicians who have spent time at the bedsides of critically ill patients have a better understanding of what works in the hospital and what doesn’t, notes Barry Silbaugh, MD, CEO of the American College of Physician Executives (ACPE), the nation’s largest medical management educational association for physicians.

When MDs bring that experience to the executive suite, it makes a difference. Of course, not all doctors — even good ones — are cut out to be CEOs.

But Dr Silbaugh notes that about half of all medical schools now make leadership training and management part of their curricula.

The ACPE also offers advanced leadership courses for doctors. With the proper management and business training, doctors can balance financial concerns with patient care in a way that many nonphysician CEOs simply would not be able to.

While some fine medical centers are run by business school grads with MBAs, this study suggests that your odds of getting the best possible treatment are greater at doctor-run institutions — one more factor to take into account before checking yourself into a hospital.

Source(s):

Barry Silbaugh, MD, FACPE, CEO, American College of Physician Executives (ACPE), Tampa, Florida. The ACPE is the nation’s largest medical management educational association for physicians.

Dr. Silbaugh is on the Board of Governors of the National Patient Safety Foundation and was named to Modern Healthcare’s 100 Most Powerful People in Healthcare list for 2009.

He is coauthor of “Landing on the Hudson River: Lessons for Health Care” (an article that appeared in Physician Executive, May 2010) with Jeff Skiles, the copilot of Flight 1549, which outlines key principles of safety and teamwork important to health care.

Love your writes.

Sharon