Since 1970, the number of administrators in health care has risen over 3000%. That’s factual, from the US board of labor statistics. If you don’t deal with that, you cannot decrease costs.
Ultimately, how well you do in the hospital is a function of how vigilant, knowledgeable, experienced, and caring your physician is - including an element of clinical insight that you can’t easily teach. It’s also a function of the vigilance of the nurses, and the efforts of those directly involved in patient care in some manner.
Having said that, most of the ‘administrative’ incursions into medicine, particularly those that have some basis in federal mandates, take caretakers away from the bedside and put them in front of computers - checking boxes and doing very general documentation that is more often than not only marginally related to the particular patients they are taking care of.
Having a caring and capable hospital administrator is a good thing, but hospitals have always had a head administrator (even those that were run by nuns - who often did a very good job). What’s different now is that the number of administrators has grown dramatically. This doesn’t lead to high quality efficient machine. It leads to increasing costs, busy work that doesn’t positively impact patient care (and often diminishes patient care), and more money going to people who don’t take care of patients.
I’m very happy your surgery went well. I’ve been a doc for a long time now, always at ‘major university hospitals’ as you put it. As part of outreach efforts, I’ve also spent time at affiliate hospitals. I’ve seen great patient care, and not so great patient care - with missed diagnoses and inappropriate treatment at both. None of those cases would have been prevented by administrators or more regulation. The administrators would have no clue about the diagnostic and therapeutic issues involved in those cases. Further, in none of those cases would the care have been flagged in any way based on the general ‘quality’ measures that are used almost universally these days. It all would fly under the radar - which it did.
I know what you mean about physician vigilance as essential to patient care. A judge whom I once worked for survived an aortic aneurysm because his personal doctor -- a longtime friend -- recognized a symptom of it and got the judge hospitalized and into surgery the next day. That afforded him an extra twenty or so years of life.
In a similar manner, when I had problems with my eyesight, I suspected that I had damage to my optic nerve from an episode of shingles and went to a low vision specialist. He referred me though to another specialist. After an examination and an MRI, I was referred to a neurosurgeon at U. of Florida for removal of a benign but dangerously large pituitary adenoma.
As it was, the neurosurgeon was a well-regarded specialist in that procedure. A surgeon relative of mine in town who knows all the doctors involved later confirmed that I had lucked out due to their quick action. It was as smooth and sure a play as Tinkers to Evers to Chance.