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Healthcare organization issues negatively affecting patient care

Think of the last time you went to the hospital, or even the last time you went to see your doctor at a private clinic. How confident did you feel about the way things were being done?

Some of these medical facilities are run like a well-oiled machine: appointments are on time, no one seems frazzled and notes/messages always get passed along and documented in patient records. But that scenario often seems to be the exception and not the rule. In many cases, doctors are overworked, no one is effectively communicating with one another and patients are not getting the attention and care they deserve. And in an environment like this, serious mistakes are far more likely to occur.

Earlier this year, an article in Slate took a deeper look at the issue of why doctors' offices seem to be so poorly run. The answers to that question are multi-layered, of course, but much of the problem can be explained by two systemic factors. The first is that most doctors receive no training in how to be effective administrators. The second is that hospital hierarchies are often compartmentalized in counterproductive ways.

Most medical schools train doctors to be fiercely independent and to take charge of their staffs. This is good when important medical decisions need to be made and orders need to be followed quickly. It is a problem, however, when doctors in private practice cannot stop themselves from micromanaging non-medical duties that should be handled by administrative staff.

Medical school training also tends to teach doctors to avoid showing any "weakness" or ignorance. Many doctors have a difficult time asking for help, even when it comes to administrative/business tasks that can and should be delegated. As a result, doctors are too often overworked and support staff may feel like they don't have the freedom to handle tasks independently.

In hospitals, communication problems often occur because administrative staff, nurses and doctors are usually managed under "different branches of the hospital hierarchy," according to Slate. Nurses may receive orders from doctors, but they technically don’t work for those doctors. Instead, they answer to a head nurse. Administrative staff may also be completely independent of doctors and nurses.

To be sure, many hospitals and private practices have found ways to work around these problems and still deliver excellent care. But why should these problems continue to exist if they make work less efficient and increase the risk of medical errors?

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