IN TEXAS. Currently.

I like to lurk around the periphery of subjects and get perspectives from people I consider to be an original source. I suspect this behavior stems from a deeply seeded distrust in politics and media. Little did I know that I might one day become one of those sources so I figured I would hop in here and donate my perspective to others who might want to know what is happening in hospitals all across America.

A brief explanation of hospital culture In order to understand this- one must take note of the divide between the three branches of a hospital. Most hospitals in America are run by health networks today but even if they were not- they would still share a lot of the same people/employees. The three branches are Medical, Administration, Service. We don’t need to discuss service personnel as they are, pretty much, what you might expect. Housekeepers, grounds keepers, security guards, a lot of temps and/or volunteers. These people are typically not that invested in the process and have a habit of just going with the flow.

Medical personnel are the core of the organization (although they are the least seen). These include physicians, specialists, technologists, therapists, nurses. They are public facing but they rarely make statements (or policies) FOR the organization. The reason they are so important is because they are the ones who generate money for the organization. A hospital’s budget is primarily determined by the amount of medical personnel they are able to attract. This creates a reverse power dynamic with administration. Although administration signs the checks, the medical personnel are the ones who make that possible. During layoffs these people are never touched. Medical personnel are typically self governed from department to department. Like miniature kingdoms. They often report to a department medical director who is often a physician and they take no orders from anyone else, even ignoring other departments. These people are very career minded and they understand that their reputation to their peers is a thousand times more important than employment status with a hospital/health network. A person who is highly credentialed and holds licenses can move from hospital to hospital and their reputation will easily follow them.

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