Administrative Harm, Professionalism and Teamwork in Medicine

Course Overview

Have you or your patients suffered from shortfalls in administrative support that have adversely affected your care? When you have inquired about the cause, have you been told, as if about an immutable force of nature like the weather, “It’s the supply chain” or “Everyone is having trouble hiring” or “It’s budget cuts” ?

Since the time of Hammurabi, clinicians have been held accountable for their decisions and actions that affect patients. Harm from clinical interventions has been much better delineated and significantly reduced in the two decades following the publication of To Err is Human. However, injuries to patients and to clinicians are increasingly arising from a newly described source, administrative harm.  

Until recently, administrators in healthcare have played a supporting role. However, as the numbers and decision-making power of administrators in healthcare have burgeoned, the vulnerability of patients to the consequences of administratively driven interventions or failures have likewise increased. Furthermore, occurring far from the exam table and hospital room, the invisibility and anonymity of administrators’ decisions is a systemic breach of the fundamentals of modern healthcare - teamwork, transparency, and accountability.

 In this course, participants will explore:

• The Five S’s of administrative domains in medicine – staff, space, stuff, systems and spirit – illustrated with real world examples of breaches in those realms
• Identifying and measuring administrative harms experienced by hospitalists and administrators
• Medical debt and private equity investment as a form of administrative harm in medicine
• Medical ethics to diagnose administrative harm
• Physician unions and professionalism as counterweights to massive healthcare systems
• Executive pay and priorities in healthcare: time for a more balanced scorecard
• Administrative/clinical collaboration to do the right thing for the patient
• Developing holistic systems of administrator-clinician collaboration featuring transparency, accountability, and bidirectional feedback for iterative improvement 

Who Should Attend

• Physicians
• Specialty Physicians
• Nurses
• Nurse Practitioners
• Physicians Assistants

Learning Objectives

Upon completion of this activity, participants will be able to:

• Discuss and identify administrative harm in medicine.
• Summarize the importance of medical professionalism and ethics as an antidote to unilateral administrative encroachment on patient care and teaching.
• Impart the crucial nature of clinical-administrative teamwork in the governance and operations of hospitals and health systems.
• Forecast the changing landscape of physician employment and healthcare organizational trends in the U.S.
• Describe the rationale for mechanisms to foster patient-centered professionalism in health care.