12: What makes a hospital so special?
The world of hospitals is over-regulated, bureaucratic and the laws are almost impossible to implement. Anyone who feels that they do not understand the laws of the German healthcare system is in good company.
On the other hand, working in a hospital is a wonderful job if you love complexity and variety and want to work with committed people.
To be successful, you have to understand what distinguishes a hospital from a normal company.
1. hospitals are service providers
Services cannot be produced in stock and how good they are is decided at the moment they are provided. Many things cannot be planned, as every illness is very individual.
In short, quality depends on how efficient the employees are at that moment, but also on how well the patient cooperates. If they do not tell you what pre-existing conditions they have or what medication they are taking, unexpected complications can arise. In addition, if materials or medication are missing at the time of treatment, for example, this directly impairs the quality of treatment.
2. a patient is not a customer because he may not be able to make decisions or provide information, for example because he is unconscious or confused. Processes should be geared exclusively to the needs of the patient. Remember: patient orientation is more than customer orientation.
3. hospitals are expert organizations
A process can only be standardized to a limited extent, as you are dependent on the individual know-how of an expert. Certain services cannot be provided without certain experts, e.g. no care for seriously injured patients without hand surgeons, no childbirth without midwives, etc.
Experts are aware of their value and may use this position to assert their own interests.
4 Ownership: Who owns a hospital?
Private hospitals have different legal frameworks and objectives than public or church hospitals, for example. A public building, for example, is always subject to public procurement law, a private building only in exceptional cases.
5. basic care vs. maximum care providers
Hospitals are differentiated according to their range of services. A university hospital and a maximum care provider offer almost everything, a primary care provider only basic services. The definition is not clear and is the subject of deliberations on hospital reform.
6 Freedom of therapy versus economic efficiency
On the one hand, the doctor should do everything possible to help the patient. On the other hand, it should only provide services that are cost-effective. (see 1st comment)
7. stakeholders: Last but not least: In a hospital, you are the servant of many masters and unfortunately these sometimes have very different demands.
More on this in episode 6 of our podcast:
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