From Government Hospital to Health Authority Board

MollyJ · Jun 21, 2002

The structure of many American hospitals is that they are either profit or non-profit and they are run by a CEO who is directly responsible to a board of directors. This is a huge simplification of a complex process. The delineation between profit and non-profit is more a tax terminology than anything else, since all hospitals are concerned about making a profit. I would guess that VA hospitals have a different structure of responsibility and I don't know a thing about it (an American government hospital that serves the needs of Veterans). VA's are also concerned about cost-savings and profitability.

I gather that the hospital you work in is changing its' governnance. I don't know that one structure is inherently superior to the other. Boards are designed to give local communities a voice in what services the hospital offers and to provide oversight to the whole operation. Boards are only as good as the expertise they contain and, to my mind, are still subject to what the CEO shares with them. Boards must exist within the reality of profitability.

How this plays out is going to depend on what rules govern boards in the Cayman Islands, who is on the board, how well they and the CEO understand the structure, and the issues of profitability and reimbursement.

Nurses in America feared, in the 1980's, when hospitals were brought by "for profit" corporations. Some of our fears were realized. Hospitals became places where profit was king, care was a step-child. I worked in the 80's for a hospital that was locally owned but then bought by HCA (a massive health care corporation). What happened to that fine old institution was a source of sadness to many. But the non-profits have had some of the same problems, related to a changing reimbursement environment.

Good luck.

Trauma Columnist · Jun 21, 2002

LOL - I want to work in the Cayman Islands too - sun, fun and warmth!!!!

Ted · Jun 21, 2002

Originally posted by QNurse
I work in the Cayman Islands . . . . .

QNurse:

This is way off topic.

Did you live/work in the Cayman Islands in 1983 (maybe 1984)??

I used to work as a "Lounge Musician" on a cruise ship called Rhapsady owned by Paquet Cruises. In 1983 (?1984) the cruise ship ran aground when some unlucky bloke steered (or didn't steer) this ship on top of the coral reef. This was off the Grand Cayman Island. It was big news (at least to the Cayman Islands) back then.

We all lost of jobs because of that mistake. I was in my early 20's when that happened. Of course I didn't save any of the money I made on the cruise ship. I barely had enough money to fly home after that accident.

Just wondering if you remember the incident.

By the way, I LOVE the Cayman Islands. Did hours of snorkeling there when I worked on the Rhapsady.

Ted

QNurse · Jun 21, 2002

Ted

I got here in 1989, but I have heard about the accident.

MollyJ

Thank you for the reply. We are already seeing some of the fears stated coming to pass