Posted on by jaygamel

Management or marketing?

This is strictly from the hip, reading a story in the Sonoma Index-Tribune on management/professional difficulties at the city’s new Community Health Center.

It seems the top three mental health professionals at the Center, two doctors and a family therapist were “let go” — ostensibly because they weren’t complying with new electronic record requirements. All three claim the head of the center is autocratic and unbearable to work with. The administrator has the favor of the Board of Directors and points to the Center’s ratings:

“If one were to ask the United States Department of Health and Human Services, however, fears about quality of care might be calmed. On Dec. 16, HHS Secretary Sylvia Burwell announced that the Health Center was the recipient of more than $46,000 in Affordable Care Act grant funds, rewarded for quality and improvement in care in the 2012-13 year.

“Health and Human Services named the Health Center among the top 10 health centers in California for “quality” – noting that it exceeded national clinical benchmarks for chronic-disease management, preventative care and pre- and post-natal care. The Health Center was also named among the nation’s biggest “improvers” in patient health.”
“The Sonoma Valley Community Health Center was founded in 1992 by Cynthia Solomon and Heidi Stovall, with a mission to provide health care for the Valley’s uninsured and underserved residents – many are agricultural workers and their families, non-English speakers, and low-income residents including the homeless.
“Its importance to those it serves would be difficult to overstate. According to svchc.org, Sonoma Valley is a federally designated Medically Underserved Population and a Health Professional Shortage Area.”

But interviews with some patients in the story found there was poor follow up in assigning new therapists and indications that the clinic is not running as smoothly as Washington thinks. There does not seem to have been a direct audit of the facility by the Federal bureaucrats, simply paperwork evaluation.
Of interest is that the Center received NO grants in the area of electronic records.
On the surface, it looks to me like the administrator is someone adept at obtaining Federal and State money, something the Board obviously appreciates, and the story itself equates size of grants to quality of care and notes the Federal evaluation is based on achieving “benchmarks” which is government speak for having the right boxes checked off on the paperwork. Tending to the sticky details of actual patient care may not be the administrator’s strong suit. While the grant paperwork may be immaculate, the day-to-day administration is definitely chaotic at the Sonoma-Valley Community Health Center.
That autocrats tend to be dismissive of knowledgeable underlings who question their fantasy paperwork to superiors does not require an exhaustive study.
I suspect another triumph of marketing over mission.

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