Understanding the Differences

One of the best aspects of my MHA program (and one of the reasons I chose it) is a clinical rounds class that places MHA students with a hospital service for five weeks to observe medical students, interns, residents, fellows, and attendings do  rounds.  I have often heard that learning on the job is the best way to learn; this experience is no different, a key to understanding others and learning about what they do is to immerse yourself in their situation.

One of the important differences that separates health care from other “business” is that most providers—who are directly responsible for admitting patients into the hospital and thus, relied upon in order for hospitals to make money—are not employees of the hospital.  It is understandable why problems develop.

The age-old health care management problem involves a disconnect between providers and management—most likely to do with a lack of communication.  This class, while admittedly too short, is an effort to help administration students (most with limited clinical experience) gain an understanding of the medical education process (and a general look into the provider’s decision-making process).

I’ve always respected physicians, but my respect has increased dramatically after just a few meetings with my care team.   Decision making can be difficult as there is always some uncertainty in the decision making process.  Limiting that uncertainty is a key to making good decisions.

Here is what I’ve come to understand well: Uncertainty rules the day in medical care.  And patients expect miracles.  While the competent provider (of which I have yet to meet one on the other side) often has a good idea/understanding of a patient’s medical problem, they just never know for sure.  Here’s the problem: (constant!) vague and incomplete information.  Besides a detective, who else deals with so much constant uncertainty?  Or if that isn’t enough, how about dealing with uncertainty and knowing the decisions made could have a negative impact on another human life?

Differences between providers and administrators will always exist.  The two have very different job descriptions with very different expectations.  The differences create a necessary balance.  While only for a short period of time, being exposed to providers doing their job is helping me visualize those differences.  The hope is that this experience will translate to a better understanding of it all.