Army Olympian Article about Hospital Commander Discipline

[aklark]

I'd only heard of the most recently and widely publicized incidences. When you're censuring 20% of your hospital leadership in two years, that seems fairly systemic to me. I wonder what Dr. Woodson is doing to correct this problem.

http://www.theolympian.com/2014/09/20/3327415/commanders-at-one-in-five-major.html?sp=/99/101/

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[az19]

This is a good read.

 

[Chonal Atresia]

This is on the nurse surgeon Horoho. When 20% of your hand-picked minions are being relieved of command, it is an indictment on leadership at the highest level. BL....hospital commanders are taking the fall for her failings.

 

[pgg]

If civilian hospitals rotated CEOs every two years after brief preparation that was half collateral duty, I'm sure we'd see similar leadership problems there too.

Military hospital commanders usually get what? Two years of experience as XOs in the preceding tour, and before that some time as directors or in other non-command-suite admin jobs prior to taking command? I've never seen a civilian hospital CEO who doesn't have a decade+ of higher level exec medicine experience. Those are people in their 50s usually who've been doing that kind of work since they finished their degrees 30 years prior. It's a lot to ask of our COs. It's amazing so many do so well.

 

[HighPriest]

I agree with that. Residency to a couple years of practice to an operational position to hospital commander. Maybe a couple of deployments in there somewhere. Or worse yet, nursing school to nursing to charge nurse to some arbitrary operational position and then a fast-track to hospital commander. These people don't even know what happens in the clinics they're supposed to manage, let alone how the hospital runs as a whole. I have yet to have an immediate supervisor who even knows what I actually do for a living. And their only backup is a handful of MSC officers who are if anything worse off and only interested in protecting their own promotions. It's amazing that we aren't running large, inefficient, highly bureaucratic morgues. But again, I argue that we have no real reason not to be better than this.

 

[orbitsurgMD]

The military system is poorly designed to develop hospital executives. The mid-grade and senior grade courses at the Naval Postgraduate School and similar intramural programs are not equivalent to excellent civilian management degree programs. The development path is relatively short, the tour lengths too short to produce the best results. The compensation in no way compares to the civilian market, the closest in government employment would be the civil service SES, which in equivalent military payscales start at O-7 (and really is more like O-9 but still is considerably less.) They should be cultivating a group who will be sent to top civilian universities for management degrees, Harvard, Wharton, MIT and the like, and who will return to take on positions under skilled mentorship that will lead eventually to command. This pathway can't follow the two year rotation cycle and produce the desired results.

 

[Kilgoretrout 65]

The nice thing about the 2 year cycle is that you can wait out an idiot commander and hope the next nurse is sane.

 

[deuist]

I've wondered about the training for hospital executives in the military as well. I noticed that on the line side, an up-and-coming leader can take several years off from his job to pursue advanced training in relevant management and leadership and will then take incremental command positions until finally becoming a colonel or general. For the medical side, it seems more common to make decisions based off of years since graduation from college, regardless of experience or training. I think the promotion conversation goes something like this: "We need a new commander. Hey, this guy has been in the military for a few years now. Let's put him in charge."