By Patrick Lynch, CBET, CCE, CHTM, CPHIMS, FACCE
Editor’s note: The opinions expressed in this article are solely those of the author and do not necessarily reflect the views of 24×7 Magazine.
I had a realization when I was in my 20s. Yes, that was 40 years ago, but my realization is as true today as it was in 1979. Here it goes: Workers change when they reach about age 45. Before that, they are risk-takers, and their main focus is sharpening their craft and doing the very best job they can for both themselves and their employers.
But as they reach 45 or 50, their focus and priorities tend to change. Once they have retirement in sight, their main criteria for decision-making changes from doing the best job possible to merely surviving until retirement. They quit rocking the boat, taking chances, and pressing to do the right thing, regardless of the consequences. Not getting fired or demoted seems to be the main priority.
When I was under 45, I saw this in the managers and workers around me. As I approached 45, I kept closely examining myself to make sure that I was not adopting this trait. As I have long passed 45, I still look around today and find that my observations from 40 years ago seem to hold quite true today: Workers over 45 tend to make decisions which are designed to preserve their station in life, rather than trying to do the very best job that they can—or even the right thing, in many cases.
Reluctance to Take on New Technologies
One example is not reaching out to aggressively attack new technologies when an expensive service agreement could be eliminated simply by receiving a little training. I saw this in the ’70s when the first lasers appeared in surgery.
Many older managers simply declared them “too complex” and the risk “too great.” So they signed service contracts for their lasers, having convinced administration that the high costs were justified because of the extreme complexity and high cost of parts. And this scenario has been repeated with anesthesia, diagnostic imaging, microscopes, and laboratory equipment.
Younger and more risk-tolerant BMETs eagerly attacked these new technologies and proved them to be no more risky (either cost or incident risk) than anything else in the hospital. But the older, “wiser,” and less risk-accepting BMETs decided to preserve their pensions by convincing administration to sign contracts.
Today, this is seen with CT, MRI, cath labs, ultrasound, anesthesia, ventilators, laboratory analyzers, and many other medical devices. I’d bet that if a survey were taken, there would be a startling correlation between the number of service contracts in a hospital and the age of the manager. I’ve witnessed many older managers who let contracts creep up in quantity by avoiding newer technologies and, instead, focusing on service of older, established, and low-risk devices.
Facing the Person in the Mirror
Are you over 45? Would you dare calculate your in-house service ratio? This is simply the value of the medical equipment that you maintain with in-house labor divided by the total value of your medical equipment. This yields a number from zero to 100. The lowest—0%—reflects that none of your medical equipment is maintained in-house; instead, everything is outsourced. The highest possible number—100%—means that everything is maintained in-house and that you never use outside labor.
From a cost and efficiency perspective, the higher the number, the better. Note: Every in-house HTM department should have an in-house service ratio of 70% to 90%. If your ratio is less than this, my guess is that you’re probably over 45 years of age and have your sights firmly set on retirement. In fact, I propose that you are already partially retired.
HTM managers are hired to reduce costs, aggressively attack new technologies, and reduce service contracts—not to simply be contract managers. After all, anybody can oversee a bunch of contracts. HTM is charged with eliminating contracts and making sure that the few remaining ones are necessary and well-priced. HTM professionals are also tasked with ensuring that the contracted services are delivered as promised.
If you are not doing this, you might as well change your title to “contract manager.” Otherwise, you’ll embarrass real HTM managers.
Patrick Lynch, CBET, CCE, CHTM, CPHIMS, FACCE, is a biomedical manager with 40 years’ experience.
This may not be true in all cases although it has merit. Sometimes the higher ups just want to get rid of the hi salary people to improve the bottom line. They will either outsource the department or hire less skilled lower paid staff.
It’s not fair but a fact of life in today’s health care environment.
I don’t describe myself as “cruising into retirement” but instead “starting to descend and thinking about putting the tray tables up”. I will admit that, at 63 1/2, I’m increasingly thinking more about where I’ll go after landing. I won’t need to go to baggage claim, as I carry my own baggage everywhere I go.
I can’t fully relate to the article because I took a different tack career wise, and while I stayed in the field, my activities were generally outside the maintenance-focused norm. I’ve spoken to that elsewhere and won’t do so here.
But I do want to bring up an issue that intersects the topic, that being more people are retiring than signing up. I recently saw posted somewhere that there will soon be 5000 BMET positions opening up but only 400 BMET students graduating annually. It’s also been my observation that there is limited upward mobility for BMETs in general across my almost 40 years in the business.
What should a 45+ year old manager do when weighing the risks and benefits of taking on a new product line for which a great deal of up front and continuing investment (training, test equipment, etc) is required in light of the so far intractable labor availability problems facing the field? Yes, the 45+ year old could choose to learn the new technologies and provide the support, but that approach has an obvious shelf date, so while that may be an effective tactic, I don’t see it as a viable strategy.
That begs the question as to whether taking on more complex technologies will increase the attraction more new members to the field. Perhaps. But it’s a risky bet on its own. How could the field lessen the risk?
I always like what Pat has to say-but he’s off the mark here-as it relates to my experience. I took on a new job in 1995, I was 49. a few years I took on PACS, I was 55. There are about 8 PACS in place and other non-imaging data storage systems added to that. The server room is almost full. We do not have to be less sharp-we have to be more sharp-by being more smart. We know the pitfalls before the order is placed, and we massage it ALL to fruition. At 72 I am ready to admit I might be slowing down-till there is a problem. Then the solutions just come rolling out. I am surrounded by people who are more current and sometimes faster-that helps keep me alive. But at 72 I want to plant flowers and watch the bees. Play music, paint and travel. Thanks Pat. Wish we could share a drink but for now, HAPPINESS!!!
Personally, at age 53, now 56, I changed my entire job focus and became more highly technically involved in a number of technologies. In the my current working environment and in the one for 15 years prior, the key star players are equally grey haired as myself. I certainly have been acquainted with individuals that act as described in the article even at younger ages than described, but I don’t equate it with aging…my 2 cents.
Pat, I am older than you and still raising hell around here. My new tactic is to jump up and down in the CEO/CFO desk until they listen. It works!!!
see you my friend
Keep it up, Marcos, my friend.
While I respect Patrick due to his many articles he has written I have to disagree whole-heartedly with this one since it is based on age. He states that that he came to his conclusions due to his observations but does not explain what the scope of his contacts/experience or places of hospital work was in order to draw his what I consider to be a biased opinion.
At 65 y/o I have 48 years in the medical field with 42 being in Clinical Engineering for a Harvard teaching hospital with 19 satellites and a 2 man department. We only have contracts on Radiology and Laboratory equipment not because of the lack of desire to learn or get involved but due to the lack of manpower (FTE’s)of my department as aforementioned.
On a daily basis I manage and work as if it were my first day on the job and take on every challenge with the attitude of correcting the issues and saving the hospital money and time on repairs most manufacturers or companies would not perform and would rather sell you a new device.
Old school techs know how to repair on a component level which seems to be a lost art and is not taught by most schools today.
This saves tons of money when comparing a $2 dollar component to repair a board versus a $2500.00 board which most company and in-house techs now swap out.
I ensure my department is trained in the latest technologies and maintain a fleet of anesthesia machines, lasers, sterilizers, central stations, medical gas equipment to name a few. We also are trained in EPIC systems and perform daily support to the users.
I mention these topics not to brag or flaunt to emphasize my point of being involved and not contracting out.
Am I thinking of retiring? Sure, but I have no set date and until I am replaced I still have a lot to offer and cannot “coast” to retirement due to my work ethics and the demands of the job.
I am sure there are places where you could “coast” to retirement but I am not in a place that would allow it nor would I consider it.
I am sure there are many others like me in both age and work ethics and hope this will support them also.
I could go on an on or write a whole article on this but I have pressing issues to work on but could not let this one go.
Keep writing Patrick for I always have enjoyed your articles just not this one.
I agree with your comments . well said .Bravo on your work ethics. Keep on Keeping on.
Thanks, Ken. You obviously are the exception. My experience is with literally hundreds of hospitals, mostly in the south and Midwest, but I find that there are a great many managers who just give up as they seek to make it to that golden retirement date. That said, I still believe that HTM professionals and managers maintain their enthusiasm much longer than many others in the working world. Thanks again, Ken. Keep it up!
Not leaving comment, don’t want to rock the boat.