Eclectic commentary from a progressive voice in the red state

Friday, November 18, 2016

Hospital administrators and a lack of courage

It’s funny how certain actions trigger certain thoughts and memories. In my case, emptying the dishwasher brings up memories of my graduate program in hospital administration at the University of Iowa, which ended in 1969 with a master’s degree.

At a departmental farewell party, the now dead, director of the program, Gerhard Hartman, publicly invited me to continue for a Ph.D. I turned down that invitation. I don’t believe I ever shared why I declined to continue my education beyond the notion that I needed to begin supporting a family my wife and I planned to start soon. The previous year, one of the doctoral students washed out right at the point when he should gotten his degree. No one knew why, but I didn’t trust Hartman or the program.

Hartman was a hard and harsh taskmaster. I acknowledge that his setting that tone for some of the academic rigor was worthwhile. But, as I reminisce about the education and the way Hartman ran the program, I think I was intuitively aware that Hartman was morally bankrupt as were some elements of the program. Even more, Hartman was mean-spirited and that translated into the way he treated people. Hartman referred to my thesis advisor in front of our entire master’s class as a “martinet.” It wasn’t a compliment.

Hartman supplemented his income as department head and CEO of the university hospital with a consulting practice. I don’t know how he marketed himself to hospitals scattered throughout the Midwest, but I know how he handled the engagements. He assigned one of the doctoral students to supervise a team of three or four master’s students to gather demographic and socioeconomic data and ultimately put together a consultant’s report with recommendations for the hospital. Usually it was it was to cure the hospital board’s edifice complex by building something — another wing, a diagnostic building. I don’t remember any reported that didn’t carry some construction with it.

The report was to be formal, typed according to university standards and packaged for presentation. And, back then, grad students used freelance typists (an entire industry in a university town) who charged by the page. The master’s students on the team chipped in to pay for the typing. I don’t remember whether we paid for duplication or if Hartman used one of those high-end copy machines at the university. I do remember my share of the project was $150 in 1966 dollars. That was after we paid all the costs for travel to the hospital on the particular engagement.

The practice went on for years and somehow no one could ever bring up how Hartman was benefitting from this practice. It turned out that in 1977, Hartman got into trouble with the university and rumor had it he was also billing the university for some of those engagement costs. In that era, standing up to such an authority figure was unthinkable. I regret not having the courage, then, but this is a case of “if I knew then what I know now.”

When I was in the health care industry, I joked that the entire first semester of training for hospital administrators was devoted to learning how to serve coffee to the women’s auxiliary. The disdain that I have developed over the years grew as I witnessed hospital administrators show less backbone than a jellyfish has continued as I morphed into an investigative and health reporter. This came to mind earlier on Nov. 2, when I saw a story out of Boca Raton in the Palm Beach Post when the Boca Raton Regional Hospital charged a woman $7,000 for the use of a delivery room — despite the baby coming in the hospital’s parking lot. But that’s only part of the story. How did the hospital respond to the publicity? “A spokesperson for Boca Raton Regional Hospital says the administration has no comment at this time,” according to WPTV of West Palm Beach.

That is only the most recent incident that offers fodder for my evolved disdain for the graduate training at the University of Iowa. In part, it is because the Iowa program has lionized Hartman, naming an endowed chair for him and perpetuating him as an icon, all the while knowing he was morally bankrupt. Of course, like any institution, the university and the program itself, fends off any criticism or information that puts it in a bad light. Some of us, I suspect, see through that.

So what’s the point of posting this now, almost 50 years later? The past eight years, the debate about health care policy in the United States has revolved around the Affordable Care Act. Now, with the Republican coup d’état, we are further engaged in that debate. When are those supposedly trained to discuss policy going to help educate the public? Or, will they just quietly serve coffee to the hospital volunteers and cower in the corner?