Remember, each Wednesday, I respond to a question posed by a student. Please submit one or more if you would like. A student asks below:
If you were to introduce a few must-read books/papers in the field of health care management/policy, what were those be? What are the journals you frequently read and find useful?
This is hard to answer honestly and not sound really arrogant. I have yet to read any books in the health care management field that are worth reading through in their entirety. By the way, this is true of management books in general. It is my experience that management books have a germ of a good idea or one or two creative thoughts. You can get the main point by reading the introduction or maybe the first chapter. After that, they are extremely repetitive and often poorly edited.
My theory is that the people who write management books who are professors in business school need to produce a document that looks scholarly enough for them to get academic "credit". Or they are former business leaders or management consultants who need to produce a book with enough physical heft to charge a high price. Both types of people load up their books with tons of case studies or examples from various situations, all of which are designed to prove their underlying thesis. They seldom give examples that are counter to their stated premise or point of view and then have the rigor and discipline to present a persuasive argument that their thesis is correct nonetheless.
So, if you are looking for interesting observations about health care management, avoid the books and look for the shorter version in articles in the Harvard Business Review or the other management magazines. Read the New York Times and the Wall Street Journal to find stories of national interest regarding health care economics and policy. Your local newspaper may have some, too. Here in Boston, we are fortunate to have a newspaper, the Boston Globe, that has devoted significant reportorial resources to health care. They often provide perspectives on broader issues, but based on local examples. Finally, the Economist magazine often has good articles and offers the advantage of a global perspective. Their stories are usually very well researched and concisely written.
Among medical journals, JAMA and the New England Journal of Medicine will often have thoughtful articles about management and policy issues, usually written by and from the point of view of doctors.
Suggestions for our student from others out there?
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17 comments:
Do you read Health Affairs? If so, what do you think of it?
The British Medical Journal, for a focus on evidence-based practice...
My vote goes to "Managing the Care of Health and the Cure of Diseases" by Sholom Glouberman and Henry Mintzberg. They argue that effective healthcare systems are difficult to lead/manage because they consist of 4 fairly distinct domains: Community (board), Control (managers), Cure (medics) and Care (nurses). Successfully integrating these 4 'worlds' is a very tricky task. View it (page 3 onwards) at http://www.mcgill.ca/files/imhl/ManagingCare-Part1-Winter2001.pdf
_Redefining Health Care: Creating Value-Based Competition on Results_, Michael Porter and Elizabeth Olmsted Teisberg
_Uncertain Times: Kenneth Arrow and the Changing Economics of Health Care_, various authors (if you're interested in the economic theory underlying a lot of health policy)
Here are my two favorite books from my days as a graduate student in health administration in the early 90's:
1) Hospitals, Health and People by Albert Snoke, MD
2) Power and Influence by John P. Kotter (Harvard Business School)
I agree with 1. "Redefining Health Care" by Michael Porter and Elizabeth Olmsted Teisberg. The must read for anyone in organizations and for personal leadership is 2. "Good To Great" by Jim Collins.
I think Atul Gawande's Complications and Tracy Kidder's Mountains Beyond Mountains are both great books about the subtleties and difficulties of providing healthcare (although if you're interested in health policy at all you've probably already read them).
Who Shall Live? Health Economics and Social Choice by Victor Fuchs. Published in 1974 this book is, IMHO, still timely. I concur with the recommendation re the HBR.
Harry Wolin
CEO
Mason District Hospital
Havana, IL
Along with Harvard Business Review, I would also recommend keeping up with other industry best practices and global economics by reading Business Week. For the business side of healthcare, a lot can be learned from HFM magazine. I now feel a little more justified that I've read approximately 30% each of about 100 mgmt books. I sure hope none of them keep something insightful for the last chapter!
I'm not a huge fan of management books, either, but there are some specific books that I think are helpful. Understanding negotiation is really useful if you're working in a healthcare setting (or any other, for that matter): "Getting to Yes" by Fisher and Ury is a good basic primer and a quick read. "3D Negotiaton" by James Sebenius and David Lax is excellent, as is their older book, "Manager as Negotiator."
I especially liked Anne Fadiman's book "The Spirit Catches You and You Fall Down - A Hmong Child, Her American Doctors, and The Collision of Two Cultures." It is an incredibly readable gem, beautifully written, and very relevant to living in an increasily diverse and multicultural society.
Anne Fadiman's brother runs the bookstore at Walden Pond.
Paul Starr's The Social Transformation of American Medicine is a classic history of American medicine, which helps explain why the medical profession is what it is and why the medical-industrial complex in America is what it is. And his web site says it won a prize from health care executives. Looking through my bookshelves, I can't really find anything that beats that book as a way of understanding American medicine as an industry--even though it was published more than 20 years ago.
If you wanted to be really outside-the-box and philosophical you could try Michel Foucault's Birth of the Clinic.
Neither are management books. In fact they may be anti-management books, particularly the second. But this might be the best kind of management book.
To echo another post, Atul Gawande has done more than anyone else to popularize the ideas of the quality movement in healthcare. So while Foucault has to be optional (!), at this point Gawande is probably required.
Thank you for these great tips!
I recommend the website "Health Politics (or is it Policy?)" by Magee. Frequently he's reporting on new national trends. I think site might be sponsored by Pfiser, but still has good content. JJA - former HMO "paper pusher".
I second "Getting to Yes."
But I also agree that management books in general aren't worth it.
I think that the real key to being a good administrator is understanding people in general and understanding the culture of the populations you're serving. I'm in the mental health end of things myself, and I generally suggest to our admin staff that people read books about people in psych recovery and about issues in the disability community. I think it's considerably more important that our staff understand the disability community (and also issues of poverty and lack of services that affect our folks) than that they understand theoretical stuff about administration. I particularly emphasize to staff that they read books written by people with disabilities and their loved ones.
I just finished reading Dr. Jerome Groopman's Second Opinions. I now feel like I've won the lottery by getting off the long waitlist for his newest book, How Doctors Think. I find Dr. Groopman's writing to be insightful, and it has been helpful in identifying flaws in my own decision-making processes. His books would be a good read for people both in and out of healthcare.
Oh, and I would be remiss if I didn't mention that Dr. Groopman works at BIDMC ;)
STIPEND PAYMENTS TO PHYSICIANS
Can you give us some insight about this ever growing trend?
thanks
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