I couldn't think of a better headline than borrowing from the provocative title of a new book, Patients Come Second by Paul Spiegelman, CEO of the Beryl Companies and Texas Health Presbyterian President Britt Berrett. The reason: We all know that in a new era of supposed accountability for hospitals and healthcare systems, the patient is supposed to be the first priority.
That should have been the case despite whatever financial methodology is being used, but, perverse incentives being what they are, maintaining volumes became more important than maintaining patients' health.
That's one reason the title, as healthcare embarks slowly, haltingly, into a new era, is so shocking.
But the two authors are being strategically provocative, to shed light on the fact that healthcare culture is often dysfunctional enough that in itself, it harms patient care. And that bothers them. Because culture is underappreciated in healthcare, they argue. Both Spiegelman and Berrett lead organizations considered by employees to be top places to work by a variety of measures.
"The irony is that the internal culture of hospitals is not very strong, especially since people have generally come to work there with a heart for service," says Spiegelman. "We have to understand that it's dominated by leaders who weren't really brought up in their silo of leadership school to know how to build a team, or play nice, or empower people to do their job."