I was hired to reorganize a totally dysfunctional subsidiary of a hospital. Hospital execs assumed that running a physician group was just like running a hospital, and had made a total mess.

The doctors were being overpaid by 50% and the revenue system had been a wreck for six years, so it was even more dysfunctional that I had been led to believe. A new VP had hired me (apparently he wanted a crony but was overruled) and I didn’t realize for a while that he was a sociopath. It was tough to report to him. He was such a freak it is difficult to describe, but one story sort of sums it up. I missed a Monday because my daughter had a baby (a few weeks premature). At the end of a Tuesday morning meeting I told the VP that I had become a grandfather, everyone was healthy, and happy. The VP ordered me to contact the Employee Assistance Program and seek psychological counseling. Say what? He could not explain his reasoning. This was one of a long string of bizarre incidents, so I stopped being nice and snapped at him pretty hard. He backed down. (The VP was not exactly an expert on family matters. His one marriage had lasted 10 months, and the hospital employees found him on a Yahoo dating site, much to their entertainment.)

A couple of months later I wrote a memo suggesting some intensive internal auditing because some of the doctors were paying fast and loose with the billing rules. I was fired and the memo disappeared from the face of the earth. About a year later he was fired. He insulted the CFO so badly she threatened to cut him into little pieces with a letter opener. He took her literally, filed a police report, it hit the newspaper, the hospital CEO was embarrassed, and the VP had to go. My former boss is now a hospital VP on the east cost. Says a lot about healthcare management.

What do you think? Do hospitals make people crazy? Or do the people who run them start out that way and then find the proper place to express their insanity?