Physicians are seen as arrogant employees, behaving as thought they belong in a executive-level position far above their rank in the Organizational Chart.
This is because of the fossilized, sclerotic workings of bureaucracy that we have internalized over the last century, accreting like a stalagmite, drip by drip. There is really no business planning left in America – what is left is business habit, business rigidity, business superstition. A certain degree of what has been taught in business schools is how to break business culture to create an institution that works.
Sadly, the traditions are entrenched far too deeply. EVERYONE knows the traditional elements of Management and Business – they have been ingrained in every portrayal of business in media for fifty years. Quarterly plans. Human Resources. Recommendations. Memos. Writeups of employees. Graded Discipline.
Even the Ivory Towers cannot reform these practices – they are rampant in the community. Taylorism, for instance, was thoroughly detested in rational management by WORLD WAR I. Yet, Taylorism and Fordism are the still-breathing remnants of business ideas that went extinct about a century ago in the take-it-seriously group.
Early on in the USSR, Stalin decided that he must attain total control, total obedience and total subjugation of the people by terror. His most difficult task was to pay lip service to Leninism – an ideology which itself was paying lip service to Marxism – but still retain the showmanship, the pomp and circumstance of the Workers’ and Peasants’ Paradise – but to strip the words of any meaning beyond absolute subservience to the whim of Stalin.
The Church of England seems kind of like this – brilliant cathedrals, showy vestments. No God, though.
He proceeded to shred, shoot and expel anyone who had enough belief in Leninism to risk standing on principles. Standing on principles, belief, makes many people nervous in the modern world. It suggests that people have individual faiths, beliefs, ideologies that compel them to act in a certain way. It is generally criticized under the rubric of “mental illness” in modernism – the refusal to act in the generally accepted way, to be politically correct.
What we have now in America can be called “Yowsah Management,” which I’ll discuss in a little bit. When society has several classes, and members of the subjugated class are not considered equal in dignity and essence to the ruling class, there forms a peculiar relationship between the groups.
Sparta, as one might remember, was composed of about 10%-20% Spartans, and 80%-90% helots; ethnographically different slaves.
As in the American South, the problem of being far overpopulated by the subjugated classes is discomforting. All efforts are made to tightly control the subjugated classes.
Around the time of the Russian Revolution, there was much intellectual disagreement and squabble about revolutionary ideas, reason and analysis. People wrote many papers and splinted into a heterodox group of ways of looking at change. There seemed to be a genuine interest in achieving a new society through good thinking.
And it failed for the same reason that Plato’s great thoughts in the Republic failed. Philosopher-kings are desirable, but they don’t hang on to power very well. Joe Stalin was generally regarded as a hard-working imbecile foreigner in the Vanguard of the Revolution. He was Georgian. That made him as ostracised as an Italian organ-grinder outside the University Clubs of a hundred years ago, in the United States. “Whassamatter you? You want-a meat-a-ball?”
Leon Trotsky got the point. He went up against Stalin, got sacked and lost on downs, ran away to Mexico and got an ice-axe through the skull. “Don’a und-a-estimate the enemy, capisce?”
Our society is divided into the Managerial Class, Corporate and Line-staff, and the chumps and bumbles who inhabit the workspace out in East Waterloo, Missouri. The regionals are not being paid to think.
There is no coherent, credible plan structuring the company – least of all in the Healthcare Industry. Make internal policies, rake off 7% of gross cash flow for Corporate, that’s how it goes.
Into all this, doctors work by making independent, self-contained plans in the care of an individual patient. That’s Corporate! Can’t have employees think on the job, unless they have a corner office.
I’ll detail how Yowsah Management comes into fruition here. Suffice it to say for now that the Corporate people command, and the regionals say, “Yowsah, boss!”
“Yowsah” is an uncomfortable phrase, a racially-laden phrase, and I use it with this understanding. I’ll clarify in the next set of discussions on “Yowsah Management.”