Posts by Bart Janssen
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But lets not get into bashing administrators. The best hospitals are where the docs and administrators work together well,...
I get that large institutions need administrators and good ones. And many of the administrators we have in the various institutions are very good.
My issue is that we have a culture that says administrators should be paid more and should make the important decisions (because they are paid more). Yes that is circular. Since administrators are often the ones making the decisions about who gets paid more it becomes even more circular.
Yet some decisions (many, most?) require expertise that administrators (no matter how good) simply do not have. Some really good managers recognise when they need to let the experts make the call and when the managers need to butt out of the decision making. But too few.
I agree the docs (or the engineers or the scientists or the lecturers or the teachers) don't really want to do administration. But that doesn't make them less important than the admin staff.
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complete loss of moral compass by his employer
snort
You do realise the only thing his employer cares about is ratings and he just guaranteed them a bigger audience. he'll probably get a bonus.
And as for why the ladies on the show tolerate him - um they are paid to sit there and smile and take whatever he gives them.
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...can someone explain to me ...
One part of the explanation is that Germany is bigger. A significant number of pharmaceutical companies and medical suppliers ARE German. Hence it is cheaper for the German health system to buy German products than for the NZ health system to buy the same products.
But another big part of it is lack of efficiencies in the system. I'm fairly sure the German people would not tolerate having the health system used as a football by incompetent politicians. That's no way to win a world cup.
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That's kind of unfair Gio.
He may well be obsessed and he certainly has stamina but it's unlikely that you can achieve that without being at least reasonably smart.
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Now, if only we could diminish the whisky & wine component...!
Never!
Some things are too important to exclude just to get another year of life - besides I'm sure I can find a study that says Pinot Noir is good for you :)
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this Chinese news item, re-creating Tiger Woods' unfortunate incident, is the freakiest thing I've seen all week
It's not a recreation - it's genuine chinese spy satellite footage - including the scenes inside the house!!!
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However it seems to me there are many such conversations, about many of the institutions that surround us, that need to be started.
Yup. And if I were to generalise I'd say that in most cases the problems occur when you start paying managers more than people who actually know what they are doing. We have a culture that says wearing a suit and going to meetings is more important (and deserves more pay) than actually doing the productive job with skill. As a result there is a point in all the "institutions" where really talented people who actually do the job of the institute have no incentive to progress because all the jobs with power (and reward) are held by suit wearing MBAs.
The health system is simply one (very important) example.
If we had a culture that said "yes we need managers (with MBAs) but we aren't going to pay them more than the engineer who designs the bridge" we might have more productivity.
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So people will fare better in less intensive industrial places, but there wont be any doctors or hospitals, cause it's expensive and anyway doctors don't like living away from cafes?
I don't think that was the suggestion. The idea is that you have lots of medical centres, some with quite a lot of gear in them, in the rural areas. Their job is to provide primary health care and also to stabalise patients for transfer to the cities where the big hospitals are located.
Any time you need full hospital facilities it is more effective to move the patient to the city. It is probably even more effective to park a patient in a nice hotel for a couple of months before and after an operation than to have a rural hospital.
The scary part is that if you do that there will, with absolute certainty, be people who die who would have survived if we had a rural hospital. And sadly the media will run the story on the front page proclaiming it as a failure of the health system and some politician will make a "stand" all the while forgetting that by not having the rural hospital there was enough money to save the lives of 10, 20 or 100 other people - sigh.
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'it's not rocket science'
duh it's biology bro :)
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there are plenty of other issues that deserve attention from this article
Agreed
However like many writers talking about health there is an underlying assumption that things can be improved by political changes. IMO the problem is always political involvement in health.
In short if spending the health budget was left to those who actually have the knowledge and experience to make the best use of the money, specifically the doctors, then there would not be all that much wrong with the system.
It is only when politicians and treasury insist on giving control to MBAs instead of MDs that you start to see waste and stupidity. Even more waste occurs when politicians start to directly interfere (eg with pharmac).
There is nothing in what the speaker says that isn't well known by actual medical professionals the problem is that over the past couple of decades fewer and fewer medical experts are involved in the decisions. Instead those decisions are placed in the hands of managers who in the end have no clue. Bitter moi?