Fast Foreward
Sportswriter and fan reactions to the firing of Chicago Bulls Coach Tom Thibodeau at the end of May once the team was bounced from the NBA playoffs almost immediately brought to mind the plight of the typical hospital operating room.
Rancor, spewed over the decision, addressed Thibodeau’s tenuous relationship with the owners and front-office management and that the front office recruited and signed the players he had to use, several of whom were fragile stars prone to injury. After all, you can’t win games — regular season or playoffs — when your marquee players are clad in street clothes on the end of the bench. It’s like trying to storm the beaches of Normandy 70 years ago this year en route to victory in World War II with malfunctioning artillery.
Now substitute all of the key participants in this NBA coaching and managing decision — or similar decisions on any professional sports team, for that matter — with hospital supply chain, OR and C-suite executives and you might start to see the silliness of how the healthcare system works and why it’s so complicated to reform.
At a pro sports franchise, the front office — typically led by the general manager, and either rubber-stamped, overseen or lorded over by the owner — drafts, picks, recruits and signs a group of players. Sometimes the coach participates in the selection process, but not necessarily the contracting. If the team is looking for a coach, however, that coach subsequently is hired and expected to deliver something — either a turnaround from a prior losing season, a winning record, a playoff spot, a conference championship or “Final” championship spot, or that conference or “Final” championship, depending on the personality or desperation of the front office and its investors and shareholders (and, to a much lesser extent, fans who pay the bills in the form of tickets and merchandise).
When expectations (no matter how outlandish) are not satisfied, more often than not, the coach is shown the exit door of the stadium.
In the hospital, where a similar cast of characters play somewhat different roles, the dynamic shifts.
Depending on the operating model, the C-suite (front office) hires or grants practicing privileges to a surgeon (coach) to repair patients (players) to get them back on the court playing the game of life. Meanwhile, the supply chain leader (equipment manager) has to make sure the surgeon has what he or she needs to operate on patients.
Here’s where the sports-to-surgery comparison veers off track. In the case of the Chicago Bulls, when the coach (surgeon) butted heads with the front office (C-suite), the front office waited for a convenient excuse to foul him out. In the case of the hospital operating room, when the surgeon (coach) complains that he or she can’t perform their duties well enough due to product selection and availability, the C-suite (front office) via the CFO puts the full-court press on the supply chain team (equipment manager) to … do something.
Imagine an NBA coach attributing his team’s dismal record to the sneakers players wear or the brand of basketball players bounce — even brands sanctioned by the NBA. Hey, wait: Now there’s an idea for hospitals. Of course, group purchasing organization membership or shareholder status (depending on the GPO operating model) or product contracting orbit as close to “official” sanctioning as possible and may be decided by the C-suite anyway, requiring supply chain’s rubber stamping.
And yet, when problems gurgle to the surface (operational, personality or latent ego), count how many surgeons (coaches) are shown the door in the hospital industry (NBA) vs. supply chain directors (equipment managers).
To fully reform a pro sports team you change coaches and players (largely through trades… hey, another idea for hospitals!) and occasionally ownership. To fully reform the healthcare system a similar model may be worth trying.
Rick Dana Barlow
About the Author
Rick Dana Barlow | Senior Editor
Rick Dana Barlow is Senior Editor for Healthcare Purchasing News, an Endeavor Business Media publication. He can be reached at [email protected].
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