Each health care professional plays an
essential, interdependent role within
the modern health care enterprise.
“The U.S. health care system is complex.
It involves a whole host of professionals
and institutions including, but not limited
to, hospitals and clinics, physicians and
allied health care professionals, pharmaceutical companies and insurance companies,” says Michael W. Posey, Ph.D., who is
professor and chair of the Healthcare
Management and Healthcare Information
Systems Management majors at Franklin
University.
Smart Business learned from Posey
about why it is important to have a holistic
understanding of the health care enterprise.
What is the current structure of the health
care system?
Currently, a person primarily accesses
the health care system through physicians
who work mostly in practices or for clinics
or hospitals. These services are rendered
on-site at a hospital or clinic on an in- or
out-patient basis. Once a patient is in the
system, payment for services is primarily
paid through insurance or through programs such as Medicare and Medicaid.
For people with insurance, there is usually some form of co-pay or portion of the bill
that the patient must pay. People without
insurance either pay out of their pockets or
their care is absorbed through a variety of
sources, including the hospital.
Today’s health care services require the
latest technology and the most up-to-date
knowledge. This has caused our health
care system to rely on technology and
interdependency at an unprecedented rate.
Medical imaging systems, billing and
accounting systems, patient care systems,
and a whole host of other devices and technological tools used in today’s health care
settings need to be constantly managed
and updated in order for modern health
care enterprises to work efficiently.
How do many medical professionals perceive their role in the enterprise?
The nature of health care and the reality of its practice make it easy for health care
professionals to focus on their particular
role and forget how they and their patients
fit into the whole. For instance, X-ray technicians may focus on taking the X-rays of
patients. They may develop the film, send it
to the physicians and be done with it.
However, that image is only a small part of
the patients’ entire care.
Also, nurses may be focused on caring for
patients on their floor. But these nurses
may be unaware of the multitude of systems within the enterprise, both personnel
and technological, which help them to provide quality care on their floor.
How should members of health care systems
perceive their place in the system?
As more systems are tied together and
more areas are merged, health care workers must have a broader view of the health
care enterprise. Instead of the old view of
health care consisting of individual areas
and/or components, health care workers
need to have a 360-degree view of the system to provide the best care.
Health care professionals with areas of
technical expertise, such as physicians,
nurses, and billing and coding specialists, are and always will be extremely vital to
the enterprise. However, to advance and
excel, health care workers not only need
their specialty area of expertise, but also
need a broad view of the entire health care
system and how it all interrelates. A basic
knowledge of areas such as management,
law, insurance, policy, finance and contemporary health care issues, can help provide
an enterprisewide view.
How can medical professionals learn how
their specialty areas relate to the overall system?
There are several ways that medical professionals can obtain this knowledge. The
easiest way is to ask others questions and
observe others within their organization.
By observing, health care workers can get
a good sense of how the whole system
works and an understanding of their place
within that whole. Also, health care workers may be able to receive cross training in
allied areas to develop a better understanding of the health care enterprise.
In my estimation, the best way for health
care workers to learn these concepts is
through formal training in the form of a
degree in a field that specializes in teaching
from a health-care-specific perspective.
For example, a health care worker with an
associate’s degree in radiology tech could
get a bachelor’s degree in health care management. This would give him both the
technical skill and the broader knowledge
necessary to move upward within the
enterprise. Someone who has a bachelor’s
degree or even an M.D. may want to get an
MBA to give her the knowledge base to
effectively manage her own practice or an
area within a health care enterprise.
Combining technical expertise with a formal degree in health care management will
enable the health care worker to be at the
forefront of today’s complex health care
system and provide the patient with the
best care possible.
MICHAEL W. POSEY, Ph.D., is a professor and chair of the
Healthcare Management and Healthcare Information Systems
Management majors at Franklin University. Reach him at
[email protected].
