Kevin Mo worked at the Terence Cardinal Cooke Healthcare Center during the summer of 2014 as a Clinical Business Operations intern while completing his graduate studies at the Mailman School of Public Health and Center for the Study of Science and Religion at Columbia University. His supervisors were Dr. Anthony Lechich, Director of Medicine, and Zain Mahmood, Director of Clinical Business Operations. This paper is a reflection of Kevin’s work experiences, a discussion of key lessons, and thoughts for future exploration. He bases this reflection on two main projects that he was involved with, IMPACT and Palliative Care, because they touch upon key themes of internship experiences. He pieces his learning together in a meditation on macro-scale decisions, micro-scale priorities, and meaning in healthcare management and delivery. : CSSR Reflection Paper Summer 2014
The Affordable Care Act, signed into law by President Barack Obama on March 23, 2010, injected forces of money, policy, and will into the American Healthcare System and has undeniably created momentum for change, whether for better or for worse. The nature of this change was highly influenced by President Barack Obama’s personal capabilities as a politician and belief/value system with regards to healthcare delivery. I will not attempt to settle here and now if the 1000 page document was a step in the right direction, but I do want to say discuss a prominent theme that is reflected in such initiatives and that has deeply influenced my summer work and perspective of healthcare management: the spirituality behind management decisions. After my work in hospitalization reduction and palliative care, I’ve come to the conclusion that both macro-level resource decisions and micro-level spirituality are both necessary factors towards meaningful scientific investigation, decision making, and healthcare management.
Macro
Decisions Most macro-scale resource allocation decisions can be viewed either beneficial, detrimental, or both depending on one’s personal viewpoint. For example, technologists and lowincome individuals may choose to view the Affordable Care Act as a brilliant step forward in that it incentivizes innovation in healthcare technology and expansion of Medicaid. On the other hand, a fiscally conservative individual might choose to view it as a huge mistake because of the huge financial cost that the federal government, which already operates at a massive deficit of half a trillion dollars, simply cannot afford. The reality is that both views can be true relative to that individual perspective, but neither is complete with regards to making a statement on the greater good. That is because the reality of management necessitates that within the entire pool of individuals affected by a decision, often times, some will benefit and some will not. And this demands both management decision-making and execution that ensures effective allocation of resources such that the greatest population of individuals benefit. Thus, managers who seek to improve healthcare delivery should utilize scientific management and accountability initiatives that define processes through measurable variables and quantification.
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The RCSS at Columbia University 