39. Common Sense

…has been lacking in all too many arenas lately.

Examples given:

  1. Less than a week after the federal government committed $85 billion to bail out AIG, executives of the giant AIG insurance company headed for a week-long retreat at a luxury resort and spa, the St. Regis Resort in Monarch Beach, California, Congressional investigators revealed today.AIG documents obtained by Waxman’s investigators show the company paid more than $440,000 for the retreat, including nearly $200,000 for rooms, $150,000 for meals and $23,000 in spa charges. (ABC News)
  2. The global economy may be undergoing a significant downturn, but the White House’s dinner budget still appears flush with cash. After all, world leaders who are in town to discuss the economic crisis are set to dine in style Friday night while sipping wine listed at nearly $500 a bottle.According to the White House, tonight’s dinner to kick off the G-20 summit includes such dishes as “Fruitwood-smoked Quail,” “Thyme-roasted Rack of Lamb,” and “Tomato, Fennel and Eggplant Fondue Chanterelle Jus.”To wash it all down, world leaders will be served Shafer Cabernet “Hillside Select” 2003, a wine that sells at $499 on Wine.com. (CNN)
  3. The CEOs of the Big Three automakers reportedly flew private luxury jets to Washington to plead for a $25 billion taxpayer bailout to save their debt-ridden industry — ringing up tens of thousands in charges even as they cried poverty.Recipients of eight-figure bonuses in 2007, the corporate cowboys used their executive perks — which for GM’s Rick Wagoner include the run of a $36 million Gulfstream IV jet — to arrive in style as they went begging before Congress.Wagoner, whose flight reportedly cost $20,000 round-trip — about 70 times more than a commercial airline ticket — told Congress he expected about $10-$12 billion from the requested bailout. (Fox News)

Now is certainly the time to cut back on excesses with the worldwide economy in a free fall.  It’s not just these one time occurrences that leave questions, either.  Are these decisions representative of the way these groups have conducted their previous business dealings?  Aside from the AIG debacle, the other two examples represent pennies in comparison to the larger dollar figures being debated.  That’s not the point.  It’s the principle of making such decisions in light of what is being discussed.  After all, perception is reality.

Translating this to health care is easy.  Remember the checklist debacle?  How often is common sense part of the discussion in decision making?  Hopefully it is often.  It should be always.

A friend recently flew to interview for a health care position.  Round trip airfare on short notice approached $1000.  It just so happened that the friend had another interview with a second organzation only a short distance from the first the next day.  Both destinations were within driving distance.  So the friend asked the first organization if they would be willing to take on an extra night in a hotel and half of the cost for a rental car (the other half being picked up by the second organization), total cost no more than $600.  The response?  Sorry, organization policy only allows us to pay for one night’s stay in the hotel.  But, the first organization responded, we would be more than willing to pay for a one-way ticket and one night in the hotel if the friend was willing to pay for the rental car and the second night’s stay.

Come on!  Common sense!  Dollars would be saved!

As finances get tighter and our operating environment gets tougher it is time to insert common sense decision-making at every opportunity.

Principle #39: One would like to think that common sense is common sense, but that’s not always the case.  Decision-making at every level of our own system will be driven by common sense.  What’s best for the patient?  What’s best for providers?  What’s best for the organzation?  To determine the answers we’ll use common sense.

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