Like other professionals, Doctors are trained technicians in their field with hardly any training in business management. Given the belief that doctors are obligated to heed the ancient clarion call of saving lives one begins to ask: “should the practice of medicine be business or philanthropy”?
Some believe hospitals should be run as not-for-profit organizations. As for me, I strongly believe that a hospital should be managed just like every other profit making organization. Thus doctors should be able to smile at their books at the end of every financial year and should not have to contend with any figure that crosses the zero borders to give a positive value.
Whilst some hospitals have been able to properly position themselves in the industry (and trust me, these few hospitals are doing very well); others have continually struggled to survive and having carried out various researches, I have been able to come up with some strategic imperatives pertinent to the survival of hospitals as business entities.
Strategic imperatives for hospitals:
• Hire professional managers- like I said earlier, because doctors are trained technicians in their practice; they need to hire professional managers to effectively manage their hospitals as a business entities while the doctors concentrate on ‘saving lives’. What you find in hospitals today are doctors that concern themselves with every administrative function of the organization- from signing of vouchers to purchase of laundry items and even to the purchase of diesel for their generator set. This as you can see is not only very distracting but also deters a smooth and effective run of business activities. Hospitals should not only employ hospital administrators to manage their businesses but should also set targets to be met at the end of every financial year. This would not only ensure a smooth work flow but also a better business environment for all stakeholders.
• Continuous innovation and improvement- I remember a research tour through hospitals in Lagos and some other parts of Nigeria which I undertook recently. It was disheartening to see most of these hospitals in various stages of decay. In fact, it was sickening just walking down their halls. It was purely saddening that some hospitals had never renewed their paint, had dilapidated tables, and beds, in fact the whole building was in utter shambles. Still, such practices would honestly hope to make money in such states. How on earth would there be repeat customers when the hospitals look like waiting death traps instead of the healing centres they are supposed to be? Another major shortcoming of hospitals is the lack of proper Standard Operating Procedures (SOP). What you find in hospitals are staff running their daily activities based on what they think should be done rather than what is supposed to be done. In most cases there is no flow of information between departments and activities are never recorded. Hospitals have no choice other than to brace themselves up to the era of continuous innovation and improvement of processes, especially because of the opportunities they stand to get from international bodies interested in community health programs. This is because such bodies actively scout for hospitals that meet certain criteria as basis for partnership.
• Stabilizing medical personnel- As easy as this may sound, it’s currently the most difficult aspect of hospital management. Doctors-in-training spend an average of eight years in a Nigerian university and staff nurses/midwives spend an average of five. Not forgetting the stressful academic torture they’ve had to contend with, they go to work in private hospitals and are paid measly wages/salaries. It’s no wonder they opt for Government Parastatals or flee the country for better opportunities abroad. This has resulted in an inability of hospitals (especially the private ones) to retain medical personnel for up to six months. Although medical personnel could easily be replaced, a research on ‘what people really want from health care’ carried out in 2011 revealed that stability of medical personnel ranked third after prompt service and quality of care respectively. This is due to the fact that most individuals prefer to confide in and build a confidential relationship with their doctors over time. It is important to state here that most hospitals have realised the importance of this factor and have begun to devise means to stabilize their medical personnel over time. Some of the methods being employed include paying competitively, designing attractive benefits and retirement plans among others.
Other imperatives include Consumer Engagement, Total Quality Management and Quality Control. Regular feedback from customers is pertinent to a successful growth of any business to ensure a proper deliverance of quality.
I would like to end this note by saying great opportunities exist in the health industry, just waiting to be explored by hospitals that have been able to position themselves rightly over time. Hospitals should therefore brace themselves to a struggle of survival and either decide to play big and survive or remain small and die naturally.
Irene Kayoma is an MBA 9 student, passionate about developing the health sector. For more information on hospital administration and management, contact her via irenekayoma@gmail.com
