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)