Top-Down Autocratic Management Out of Style

Top-Down, Autocratic Management Out of Style

The world witnessed an unexpected and amazing phenomenon this year in Arab countries which came to be known as the Arab Spring.  In some of the strongest autocratic countries in the world where the government tightly controlled their people and flow of information to the people, through the internet and social networking site, the people rose up, organized, and demanded change.

Most non-profit hospitals and health systems have operated with a system similar in many ways to the autocratic governments in the Middle East. Because they are private non-profit businesses, they are able to operate in secrecy and autonomy. They receive exemption from local property tax, state income and sales tax, and federal taxes. They receive grants from the federal government and are able to solicit and receive

tax exempt donations from the public. They use public finds with minimal disclosure and accountability.

As is the case with Sarah Bush Lincoln Health Center and System and other non-profit healthcare systems in the area, they pick their own board and administrators without input from the public.  They have closed meetings and do not make the minutes available to the public.  They carefully "spin" any news or information from their organization through their well funded media department.

Ths organization is not required to and seemingly does not seek or desire input from the general public. Anyone wanting to communicate with the board must go to great effort to do so and go through an administrator who might or might not communicate their request. (In a 3 hour effort to find board members addresses and e-mails, I was only able to find a handful).

The only information on SBLHC finances and operations must come from the federally mandated Form 990. This report is 18 months old by the time it is available to the public making this information dated and not relevant.  Other requests for information is given a polite response, "Since we are a private non-profit business we are not required to release that information."

This Autocratic Management Style is Condescending to the Public

Autocratic management styles whether governments in the Middle East or in non-profit medical centers in America is condescending to the public.  It is an attitude of "we know, you don't; you are not intelligent enough to understand; you don't really need to know what is going on; we are smarter than you; just do what we say, pay your bills, and we will take care of you; just trust us."

What has this total control over health care in America gotten us?  It is the most costly system in the world, yet ranks way down the list in quality. Healthcare costs are rising twice the rate of inflation and are unaffordable to more and more Americans. The system operates independent of free market principles under which the rest of the economy operates.  It is a national crisis.

An "Arab Spring" in Health Care is Coming

Hospital boards, administrators, and doctors need to wake up and smell the coffee.  The public will only put up with so much. Your power may stifle the traditional media, but the word will get out and people will demand reform.  You can only fool the public so long.

Why not voluntarily open the books to your finances and operations and provide timely and relevant information to the public on the internet?  Why not open your board meetings to the public and publish the minutes for information that does not interfere with privacy laws?  Why not lift the veil of secrecy?

Dr. Don Selvidge

Action for Affordable Healthcare (aah)

Top-Down, Autocratic Management Out of Style

Strength of Indicator response:  0-no/ no response  1- Weak    2. Median  3. Strong

Ask Dr. Gott on Medical Arrogance

Peter Gott, MD on Medical Arrogance

In this morning's newspaper, Dr. Peter Gott who writes the column "Ask Dr. Gott" announced that his column will no longer be available for newspapers, but will only be on his website.  In today's column he reviews what he feels has made his column successful.

"Perhaps part of my success stems from the fact I admit I'm human.  ...I did and still do refer to physicians as being arrogant, pompous, egocentric, and irrationally independent. We pontificate, are self righteous, impatient, and materialistic, have obsessions for fast and expensive cars, believe we are infallible, a step above most people and entitled to fringe benefits and large investment portfolios because of the MD behind our names."

Dr. Gott's description while not true of all MDs and DOs, painfully hits the mark for far too many.  The arrogant attitude described is carried on into the hospitals and medical centers in which they work.

These days most of these organizations are non-profit, and increasingly employ their own doctors. But don't let the word "non-profit" fool you.  These institutions are structured to render maximum income for the doctors and administrators who use tax free offices and equipment paid for by the public. These are usually the most profitable business in an area with the highest paid top employees, the doctors. 

These institutions resist any meaningful disclosure about finances and operations except where forced to by the US government.  They resist public accountability and carefully control information flow allowing only the "spin" by their public relations department to be released. Since they are so powerful, and exert so much influence, no newspaper dares dig deeply into their finances and operations.

In spite of huge profits and back breaking fees, these institutions still arrogantly ask the public to volunteer to run certain programs and make donations so they can buy more equipment and build more buildings. This allows them to charge higher fees and make more tax free money.

Thanks to Dr. Gott who over the years always treated natural remedies sent in by his readers with respect even though they were not the medically "sanctioned" treatment. He admits that he does not know it all and realizes there may be some validity in  alternate remedies. We will miss his column.

More to come,

Dr. Don Selvidge

Action for Affordable Healthcare  (aah) 

Columnist Peter Gott,MD Got it Right

 

http://www.drdonsopinion.blogspot.com/ 

Needlessly Delayed: SBLHC's 2010 Form 990

 

(Note to administrators and board of SBLHS:  I know you want input from the community.  I thought you might be interested in my blog on healthcare since much relates to Sarah Bush.  I took the liberty of sending the latest entry and will continue to send updates as I get them written.  If you do not want to receive these, please let me know and I will delete your name.  Dr. Don Selvidge 235-4664, 962-1764 )

 

Needlessly Delayed

Sarah Bush's 2010 Form 990: Income/Expenses

The federal government requires that private non-profit hospitals give a yearly report

on Form 990.  The purpose of this report is to give the community the hospital serves an opportunity to look into the hospital's finances and operations.

Form 990 includes tax status, income and source of income, expense breakdown, net assets, programs and costs, board members and pay of top staff.  It also asks if there are any self-dealing transactions, conflicts of interest, lobbying activity, and other questions.

In my opinion this report is filed needlessly late (12 months after close of financial year). This time included 6 months plus two requested 3 month extensions putting its filing date for year ending June 30, 2010 at May 2, 2011.  I am told that it actually takes this much time to get the data together, have it audited, and get it filed.  

 I am not convinced. An organization as highly organized as SBLHS with such talented people and extensive resources surely can get this report together within 6 months or sooner if they wanted to.  If the auditor causes the delay, I think they need to get another auditor.  Could it be they want to make the report's release to the public as old and irrelevant as possible? 

In the rest of this article I will give some information and observation on the SBLHS income.  In future postings I will talk about expenses and other information. 

SBLHC's Financial Summary

In the area of income the reports gives SBLHC 2010 gross receipts at 368,187,007. This represents an increase of $140,734,700 or 38% increase over the previous year. Gross receipts is not actually collected, but is what is charged for services. (I'm confused.  Why do they call it gross receipts?)

The amount actually collected for the year was $193,981,053 was increased by 11% over the $173,138,671 collected in the previous year.  I would be interested in what specifically brought the additional 11% increase in income.

The investment income for June 2010 year was $8,824,515 up from -$4,602,808 the previous year  an increase of about 300%.  I was unable to find where these investments were made.

It appears that after all is said and done, SBLHC recorded $18,471,574 profit up from $3,051,055 for the year an increase of about 600%.

I hope to sponsor a meeting in the future inviting a representative of SBLHC to answer all the questions we may have about the Form 990 for year ending June 2010.

 

I will continue to analyze SBLHC's Form 990 in future postings. I believe they are doing a great job. I also believe the public should be fully aware (and apparently the US government thinks so as well) of their finances and operation.

 

More Later.

 

Dr. Don Selvidge

Action for Affordable Healthcare (AAH) 

http://www.drdonsopinion.blogspot.com/

Needlessly Delayed: SBLHC's 2010 Form 990

Needlessly Delayed

Sarah Bush's 2010 Form 990: Income/Expenses

The federal government requires that private non-profit hospitals give a yearly report

on Form 990.  The purpose of this report is to give the community the hospital serves an opportunity to look into the hospital's finances and operations.

Form 990 includes tax status, income and source of income, expense breakdown, net assets, programs and costs, board members and pay of top staff.  It also asks if there are any self-dealing transactions, conflicts of interest, lobbying activity, and other questions.

In my opinion this report is filed needlessly late (12 months after close of financial year). This time included 6 months plus two requested 3 month extensions putting its filing date for year ending June 30, 2010 at May 2, 2011.  I am told that it actually takes this much time to get the data together, have it audited, and get it filed.  

 I am not convinced. An organization as highly organized as SBLHS with such talented people and extensive resources surely can get this report together within 6 months or sooner if they wanted to.  If the auditor causes the delay, I think they need to get another auditor.  Could it be they want to make the report's release to the public as old and irrelevant as possible? 

In the rest of this article I will give some information and observation on the SBLHS income.  In future postings I will talk about expenses and other information. 

SBLHC's Financial Summary

In the area of income the reports gives SBLHC 2010 gross receipts at 368,187,007. This represents an increase of $140,734,700 or 38% increase over the previous year. Gross receipts is not actually collected, but is what is charged for services. (I'm confused.  Why do they call it gross receipts?)

The amount actually collected for the year was $193,981,053 was increased by 11% over the $173,138,671 collected in the previous year.  I would be interested in what specifically brought the additional 11% increase in income.

The investment income for June 2010 year was $8,824,515 up from -$4,602,808 the previous year  an increase of about 300%.  I was unable to find where these investments were made.

It appears that after all is said and done, SBLHC recorded $18,471,574 profit up from $3,051,055 for the year an increase of about 600%.

I hope to sponsor a meeting in the future inviting a representative of SBLHC to answer all the questions we may have about the form 990 ending year June 2010.

More Later.

Dr. Don Selvidge,

Action for Affordable Healthcare