So why is healthcare political?
Like any industry, healthcare organizations are run by human beings. As humans, we all show up for work with our own set of opinions, emotions, and self-interests. We are also social creatures who develop and maintain relationships. These relationships become complex—and therefore political—when we are put in a position to compete with each other for time, attention, and limited resources.
For example, let’s say a group of orthopedic physicians want more control over a hospital’s orthopedic service line. They want an increased ability to make operational decisions in how care is provided. Oh, and they also want a larger portion of the reimbursement from payers. A political game these docs might play would be to lobby the hospital CEO to partner with them in building a new facility together. If negotiations fail, their backup position may be threatening to compete with the hospital if their demands are not met.
Healthcare is also political because of individual goals (personal or professional). Throughout the organization, operational decisions are made as a result of advancing someone’s goals. Finally, the business of healthcare, like other industries, is political because of power, either of those who hold the power to make decisions or those who hold the power to influence those who make decisions. For example, a CEO sitting atop the organizational chart is going to hold more power than others in the organization to make decisions. That’s formal power. Separately, there may be others in the organization, such as a vice president, a department director, or even the administrative assistant, who have the ability to influence the CEO in making decisions. That’s informal power.
Driven by promoting their own self-interests, healthcare workers find ways to align themselves with others who hold power in the organization (formally or informally). They’ll hold secret meetings to discuss and negotiate deals, just like politicians in Washington, D.C. Whether it is senior management, physicians, employees, or patients, each group has a viewpoint on how the organization should conduct its business.
If you want to navigate the politics of healthcare successfully, always be mindful of who holds formal and informal power within your organization as you are working on any compliance matter.
Something I didn’t realize when I started in this line of work is that the most difficult part of the job is navigating the politics of healthcare. That is not to say there aren’t challenging times involved with conducting investigations or understanding the regulations. Figuring out how to effectively communicate with others though, in my opinion, requires a lot more mental energy. It is the politics, not the work of a compliance officer, that will force you to wrestle with questions like:
“Should I raise this concern in this meeting or say something after the meeting?”
“Who in the organization needs to know that I am working on _____?”
“When do I need to tell others about _____?”
“If I tell my primary audience about _____, will it get repeated to others without my knowledge?”
As we move forward, I will talk through some tips and key strategies that will help you with navigating these kinds of questions in order to operate a more effective compliance program.
So where does compliance fit into the politics of healthcare?
Stay tuned and we’ll cover that topic in the next article, along with how to develop a political strategy rooted in productive politics.