Joel on Software is one of the websites that I occasionally read. Joel writes well about technology and business -- and his foreward to Rick Chapman's new book is compelling, and relevant to medicine. Joel's argument is that developers should run software companies because the "get it" in ways that non-developers simply wouldn't or couldn't .. and so will avoid the mistakes that the "non-geeks" would make.
I'll make the same statement for medicine -- and even IT in medicine:
a) Medicine is not "just a business." As I mentioned last April, there is more to what we do than make money. If we really are here to enhance the quality of the lives of others -- then our leaders must have the same core beliefs as we do. Making money is scondary - providing our services is primary. Yes, we need to pay the morgage - and the salaries of the nurses, and the phone bill, etc ... so ... yes, we need good business skills. But good business skills are not enough. In healthcare, there needs to be a passion. Yes .. healthcare is not unique .. and there are many professions that share similar qualities: education, some legal services, clergy ... ? journalism?
b) Decisions in healthcare technology can't be made by mainstream IT managers without experience in healthcare. Why not? For the same reason that Joel asserts that programmers should run software companies. One shouldn't have want to have to explain to an IT executive what a CBC is ... nor should one have to explan the difference between Java and Javascript. "duh" says the physician/nurse/PA ... "duh" says the geek ... but who knows both? Sadly, there are rather few.
My neighbor is a manager for a big company that makes steam turbines for the Navy. He manages a team of workers, and ... for the most part ... he really understands what the workers are doing. He tells me that he would have a hard time managing them if he didn't quite get what they were doing.
Managers of software developers have a much tougher time. They can't always know the details of the work that the workers are doing .. since technology is moving so fast that the workers will nearly alwasy know more about the technology than than the managers do.
? or do they? Shouldn't a good manager keep up on this? Just as a good physician will always keep up on the most recent research? If web develoeprs start using Flash rather than DHTML .. shouldn't the manager learn about flash too?