Saturday, July 30, 2005

Budgets, Budgets, Budgets

My apologies for the lack of posting here as of late. I've been covered up with capital budgets, operational budgets, productivity standards, and now moving to JCAHO prep for an inspection coming up next month.

I always find it interesting that we're required to submit proposals for the next capital budget year in June. Number one, its hard to get quotes for equipment/software that will last until the new year. Secondly, for those in Radiation Oncology, ASTRO isn't until mid-October so you have to try to budget for equipment that will not be released or seen until after your budget is submitted.

I find capital budgeting interesting. Basically, in our system, you're competing with other service lines for a limited amount of dollars. For us, our main competition is imaging. Since the dollars are limited, thorough proposals where the high tech lingo is explained in layman's terms for executive management teams with proformas that demonstrate revenue and income usually win out. You would be amazed at some of the shoddy proposals I've seen submitted.

To top things off, our system heads right into operational budget prep after capital is submitted. Operational wouldn't be that bad if there were only one cost center. Even that isn't that bad but what is the real kicker that has came on the scene in the last few years is productivity monitoring.

Percentiles, targets, yada, yada, yada. I think its all a bunch of hocus pocus in our field. I see where these type programs might work for service lines such as nursing that have large numbers of employees and can flex with volumes. But Rad Onc?, I can't see it. Number one you need a basic number of staff whether you treat 1 patient or 40. Number two, I haven't a center that accurately reflects the number of procedures they perform. They either under report due to incompetentcy or they over report to make themselves look better. Either way, in Rad Onc it is extremely hard to compare apples to apples. Thus, if your comparisons are flawed from the "get-go" the whole production is shot. I could go on but, that's another post another day.

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