The finance and healthcare administration at UW Health has radicalized me away from working in American healthcare. The finance processes are disorganized, mostly unnecessary, and there is no rhyme or reason as to how or why they are done. Processes that should be the bread-and-butter of financial administration, such as budgeting, have been complete disasters. The budgeting process has literally left clinical managers in tears. The only well oiled processes are diffusion of responsibility and political maneuvering.
Clinical and operational leaders are generally good. They stand up for their teams and take on a lot of responsibility. Seeing how finance and admin leaders treat them makes me sick. These are the people who actually help patients and keep the business running getting constantly questioned and berated by box-tickers and taskmasters. People who have mostly never taken care of a patient in their lives feel entitled to make decisions that will effect patient care.
Justifying increases to patient care, which would improve community health (and actually be remarkable healthcare) is nearly always an uphill battle. There will never be enough evidence to justify providing better services to patients, and leaders will just sit on their hands or keep coming up with new questions hoping you run out of steam. If, however, there is an opportunity to decrease services, you can rest assured that they’ll have no problem doing that. There will be no roadblocks to not replace someone or overworking and underpaying people. If there is an opportunity to make a decision that will leave patients with less care or take away something that makes employees happy, you can rest assured that finance and administration will go forward with that, and then not communicate it.
If you are thinking about working in healthcare finance because you want to make a positive impact on patient care and feel like you are helping the community by proxy, then you seriously need to reconsider what it means to work in finance. No good news has ever come from finance and you will be almost universally despised. On the other hand, if you have a passion for making the people you work with frustrated, inundating clinicians with useless questions, and have a knack for politics that rivals classical Athenian rhetoric at the Acropolis, then you might feel right at home here.
