After a series of never-ending discussions regarding the future of our favorite West Coast hospital, we finally got a resolution. The hospital has been saved and it will not become a faceless profit-making machine, but a paradise we would all love to encounter whenever we have no escape but to be in a hospital. The story of the hospital's announced financial collapse has been dragging on for weeks now and the resolution is anything but realistic even by TV standards. Whatever the case all is well that ends well and providing the ratings follow, we will have many an extra season of Grey's Anatomy.
Two issues that deserve comment have however been raised. the first one, a minor one compared to the second is how a foundation in America can apparently dispose of 175 million to please a lover and to push a not so prodigal child. I sincerely doubt the statutes of any foundation or trust would allow for such an absurd decision. If they do, then frankly speaking the tax advantages attached to any such foundation should be promptly revised. Any rich person should be allowed to dispose of its wealth in a any legal mean it sees fit, but the moment it asks Uncle Tom to kick in some money, in whatever form it is, then there ought to be a cross-check of the decision. In the happy-ending, last second resolution to Seattle Grace's crisis there is neither of this nor is there a hint of the obvious abuse. The fact that it is all for a good cause, we do want to see more of Meredith, Derek and co. hardly justifies it.
The more interesting issue raised by the episode is however the one concerning the management of an institution that has been in financial dire straits practically since episode one of the series. The original benefactor (Julian Crest, the man willing to raise 175 million) points out none of the five millionaire doctors willing to invest the money they got as compensation for the plane crash has actually any management experience, in hospitals or anywhere else for that matter. When the Fab 5 bring in Richard as a last minute savior I frankly wondered if that would win the day. Thankfully it did not, at least a piece of realism in an otherwise "Wonderful Life" type of episode.
The issue raised by Julian Crest is however a good one, and one that as far as I know nobody around the world has honestly addressed. Hospitals are generally run by doctors under the wonderful excuse that only a doctor can run an institution such as a hospital. The usual explanation is that only a person capable of healing a person can tell you how to heal another person. Obviously it is necessary to understand how the heart works before advising on the proper treatment for any major heart issue? Is it really? Then what do you do if three extraordinary cardiologists (as recognized by their peers) suggest three different treatments. Someone must make a decision, and that someone must be above all a manager. Someone understanding statistics and knowing his people. He probably also needs to understand the patient's psychology. But, does he have to be an expert cardiologist, or even an MD? Managing people is tough, often it is a skill you are not born with, but one you acquire with experience and some level of training. Do we really want Derek to become a top manager? Isn't everyone best served if he becomes a better surgeon instead?
Now, a hospital manager has far more duties than medical decisions. He is running a company with a staff hundreds if not thousands. He needs to know if that airline where Lexypedia and Mark lost their lives is safe. He needs to know what his hospital liability insurance is. You cannot do that and spend 23 hours in the OR. By the way, a proper hospital manager could question 36 or 48 hours shifts for his staff. No plant, even in China or Bangladesh would ever force its employees to endure such working conditions, because not only productivity will go down, but because it is plainly and simply dangerous. Hospitals, where life and death decisions are made constantly ignore this basic principle third world plants have understood.
Yes, I was disappointed, the Fab 5 did not come up with a manager to run the place for them, not a doctor, but a manager they would chose and get along with, and one that could actually prevent the next financial collapse of Seattle Grace.