Wednesday, October 29, 2014

The vultures are at work

Two articles in the Boston Globe set forth the view that Gary Gottlieb's leaving Partners Healthcare System was seen "as a way to ease the pain" of the controversy surrounding the big health system as "regulators grew increasingly hostile toward Partners’ desire to expand, tens of millions of dollars in losses piled up at a new in-house health insurance arm, and some doctors and hospitals bristled at a push to standardize clinical practices."

This is typical after-he-left kind of nitpicking in academic medicine.  The comments in the article may or may not have something to do with the real reasons Gary is leaving.  More accurately, each constituency within the organization is now using the Globe, trying to influence the board to pick someone who will protect their interests. 

Overall, to say Partners faced a string of setbacks is ridiculous when we look at the big picture.  They continued in their market dominance and got the state legislature and the AG, both, to accede to laws and rules that will maintain that dominance for years to come.

But whether or not the comments are true, their publication validates my assertions that the board is going to be very timid about bringing in a change agent at this point.  This is a board that does not like to take chances of getting splash-back from the faculty or other inside players in town.  They will hire a low-risk, steady-as-you-go kind of person.  Welcome to the General Motors of twenty years ago.


nonlocal MD said...

It is nice for Partners' physicians that they are 'set for life', as you describe in your 2 posts, by the revenue streams and feeder practices, etc. However, that dinosaur system is a dead man walking, and the sooner they realize that the better. If Gottleib truly was trying to bring standard work and coordination to what must be the world's biggest set of academic fiefdoms, then his successor must continue this work, not abdicate it. Their money will protect them for awhile, but changing incentives can make them fall far and fast.

Paul Levy said...

If he was trying to do that, it failed. PHS is YEARS behind the real leaders in the industry when it comes to clinical process improvement.

Even the Brigham fails to adopt the sensible approaches laid out by their most prominent faculty member, Atul Gawande.