Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, March 23, 1993 TAG: 9303230378
SECTION: EDITORIAL PAGE: A-5 EDITION: METRO
SOURCE: ROB ROBERTS
DATELINE: LENGTH: Medium
A BUSINESS IT'S NOT
HEALTH care, and how much government intervention is required to reform it, was a major issue in the recent presidential campaign. Many Republicans, contending they didn't want "trickle down government," argued it's best to intervene as little as possible: Businesses suffer from regulation, which stunts the growth of free enterprise.That axiom may have some validity if the subject is, indeed, business. But are health-care facilities businesses?
Let's forget the technical, working definition of a business, and look at the more subtle, defining aspects of a business. Besides profit margin, a business has many more revealing qualities essential to thrive or even survive. I think health-care facilities fall short of these qualities.
Hospitals are probably the best generic example to look at.
One of these requirements is efficiency. A couple of years ago, I checked into a hospital for eye surgery. I was told by my surgeon to simply report to the main desk and they would check me into my room.
I approached the front counter and they sent me to another desk. All I had to do was follow the floor marked with the green line to the floor marked with the red line. I found the right desk and had to fill out some "standard" forms. The receptionist sent me to another area. This time I had to follow the green line to the red line.
Twenty minutes later, I found it. I was again to fill out some forms in triplicate. "I guess rules are rules," I thought. After I finished the forms, I was sent back to the main desk where I began. I hoped I could remember my lines.
At the front desk, the receptionists said that I had no more forms to complete, but unfortunately they had lost my chart. I was going to have to wait in the lounge until they found it. I waited patiently in the lounge - and waited - and waited. After sitting and reading current magazines on whether Ford or Carter would win the election, my patience was exhausted. I had followed their stupid procedure and it had gotten me nowhere. I walked up to the receptionist.
"Ma'am, I have been all over this place and have waited for over an hour," I pointed out with exasperation. "When do I get checked in?"
"You'll be checked in when you're checked in," she said sternly. "Now go sit down."
"I don't have to take this abuse," I thought. "Who does she think she is?" On my way back to the waiting room, I was in a quandary about whether my surgery would begin without me. Efficiency is not one of a hospital's stronger attributes.
Another defining aspect of business is customer satisfaction. In college, at the end of every semester, the students get a questionnaire to evaluate the performance of their instructors. I have never received one for a doctor. They might include questions like:
Did your doctor make you feel at ease?
Who performed the examination; a doctor, nurse, or other? Explain. Were you kept up to date on your prognosis or did you have to guess your condition?
In every visit I have made to the doctor, I have always had to inquire. When I ask what my blood pressure is, they say it is normal. When I inquire about my temperature, they reply it is normal. I get more specifics from the quarter machine at the drugstore. At the dentist, it seems as though I'm the one pulling teeth.
I also never get a money-back guarantee. When I was in the hospital for eye surgery, I had to spend the night. When I ordered dinner, the Salisbury steak looked like a cross between a briquette and a cow patty. It always seemed that by the time I received my food, the kitchen was closed. At Shoney's, I could always return it if I was unsatisfied. Also, I didn't have to pay $3.95 for a pudding cup.
Finally, another imperative part of business is competition. However, when no one knows how much you charge, how do you set competitive prices? When you buy a car, the cost is listed on the window along with the price of options. Wouldn't it be refreshing to see a similar "price list" in a hospital? For example, the cost of open heart surgery is $8,000 - anesthesia is extra. Also, "If you get a bypass now through Saturday we'll give you $1,000 cash back." Hey, can't beat that.
In addition, if these health-care facilities are competitive, why do they share their secrets? I mean surgeons are often employed at several hospitals at once. Doesn't that place them in a position to sell secrets? My girlfriend had to sign a document when she was hired at Pizza Hut promising not to work for a competitor for one year. I know Lee Iacocca worked for Ford and Chrysler, but not simultaneously.
A hospital doesn't contain the business facets of efficiency, customer satisfaction or competition. It would be absurd to try to implement these aspects. It also would be absurd to define health-care facilities as businesses. Any time the service provided is required for life, regulation is required.
Rob Roberts of Roanoke is a student at Virginia Western Community College.