MBA-squerade: When Your Clinic Is Run By Someone Who's Never Seen a Patient
Once upon a time, leadership meant having vision, wisdom, and maybe a calloused hand or two.
Now it means having a LinkedIn bio that says “strategic thought partner,” a six-figure bonus for “cost-saving initiatives,” and no actual clue what its workers actually do.
Especially in healthcare.
The Rise of the MBA Medic
In a not-so-distant past, hospitals were led by… what’s the word? Oh right — doctors. People who actually knew things. Like how to interpret a chest X-ray, talk to patients, and maybe cry in the call room once a quarter.
Then came the MBAs.
Now, your hospital is run by someone who once took a Harvard Business School webinar on "strategic planning" They use words like value units and human capital and think “burnout” is a temporary morale issue you solve with a company-branded hand sanitizer bottle and Friday pizza party.
What Could Go Wrong?
Here’s the inconvenient truth: When leadership is disconnected from the realities of the frontlines, everything falls apart.
Administrative bloat is real: From 1975 to 2010, the number of U.S. healthcare administrators grew by 3,200% (no, you’re not imagining that extra zero…), compared to just 150% growth in physicians.
Patient outcomes suffer: A 2011 article published in The British Medical Journal showed that hospitals led by physicians outperform those led by non-physicians across nearly every quality metric.
Burnout has skyrocketed: Nearly 63% of physicians reported feeling burned out in 2022, with top reasons being bureaucratic tasks, lack of autonomy, and being treated like billing code generators.
But yeah, tell me more about the new Epic “patient experience dashboard.”
The Leadership-Delusion Feedback Loop:
The board hire someone “innovative.”
That special someone implements a flashy restructuring plan to “disrupt the status quo.” You know, the one where administrators outweigh clinicians 10 to 1.
Staff morale tanks. Patients suffer.
The new metrics look confusing but promising (thanks to data manipulation and vague performance indicators).
“Innovative leader” gets promoted, hires his cronies, tanks the budget, and is never seen again.
Rinse, repeat, implode.
Strategic Planning: Where Good Ideas Go to Die
Let’s take a moment to appreciate the beautiful, meaningless theater that is strategic planning.
This is where modern day leadership really shines. A dozen administrators in muted earth tones gather in a fluorescent-lit conference room, armed with sticky notes, synergy, and zero clinical experience. They pass around key phrases like:
“We’re building the plane while flying it.
Translation: “We have no f%#king clue what we’re doing.”
“We need to be proactive, not reactive.”
Translation: “We're already too late, but we can still play pretend…”
“We need to optimize workflows.”
Translation: “We’re cutting staff and resources and expect you to do more with less.”
“Let’s identify the low-hanging fruit.”
Translation: “We want easy wins so it looks like we’re doing something.”
And my personal favorite….
“We’re committed to full transparency.”
Translation: “We’re going to vaguely allude to things after we’ve already made the decision and pretend you were involved.”
Spoiler: they’ll “circle back” until you’re dizzy, build an “ecosystem” that runs on useless spreadsheets, and optimize your soul into a pulp.
Values Statements and Collective Obedience
But wait — it gets better.
Let’s pretend, in an alternative reality, your institution handed out a list of mission statements for all staff. Not values. Not collaborative principles. Commandments.
As in:
Thou shalt be relentlessly positive, never criticize leadership, and always pretend you’re fine even when the system is eating your soul.
And yes — you have to sign it. A formal agreement to suppress your humanity in exchange for a badge, a paycheck, and a company-branded mug.
It’s institutionalized toxic positivity: a culty cocktail of control and fake smiles, where you’re policed not just in your actions, but in your tone. Real emotion? Inappropriate. Dissent? Dangerous. Questioning a policy that harms patients? Unprofessional.
Meanwhile, the people handing down these commandments don’t follow a single one themselves. But hey — rules are for the help, right?
It’s not culture. It’s compliance theatre. And you’re expected to clap for it.
Toxic Positivity: The Smile-Plastered Lie
Of course, to sugarcoat the authoritarian vibes, you’ll also be invited to participate in a lunchtime “Gratitude Circle” where you’re expected to share one thing you’re thankful for — like still having access to coffee in the staff breakroom. In true theater fashion, something like this can, of course, only occur during your unpaid lunch hour.
This isn’t support. It’s corporate gaslighting. You’re not burned out because you’re overworked, underpaid, and morally injured — you’re just not being positive enough.
It’s like someone set your house on fire and then handed you a candle and said, “Have you tried setting intentions instead?”
And Then There’s Healthcare…
Healthcare should be sacred. But in America, it's run like a tech startup with a God complex.
Your hospital isn't failing because your nurses and providers aren't “resilient enough.” It’s failing because it’s being run like a hedge fund with a stethoscope.
Hospitals are firing bedside staff while replacing them with another 15 administrative assistants. They're cutting down nursing hours while investing in patient experience consultants who’ve never spoken to an actual patient.
How It Should Be
Great leadership isn’t flashy. It looks like this:
Walking the floor.
Asking real questions.
Admitting when you don’t know.
Giving people the time, tools, and trust they need to do their jobs well.
It doesn’t look like closed door meetings with other suits, quarterly budget cuts wrapped in pastel lingo, or wellness webinars led by Sharon from HR.
So…What Do We Do About It?
Start by asking this question in every meeting, hiring process, and policy change:
“Has anyone here actually done this job before?”
And if the answer is no — maybe that person shouldn’t be making decisions that impact the health and humanity of thousands.
We don’t need more buzzwords. We need leaders who remember what it feels like to be human.
Or at least someone who’s been peed on during a code blue.
If your hospital feels like a burning cruise ship captained by someone who's never seen the ocean… it’s not you. It’s leadership.
And if your manager has a vision board but no idea what you do all day?
Run.