The Ethics of Power:

From the Shredding Machine to the Spin Machine:
What Would Grandpa Say?

by Bruce Sogolow

My grandfather had a saying for everything. When we would watch the evening news, he would often comment about the plight of our world by saying, “The great tragedy of human existence is not that we don’t know what to do, but rather, knowing what to do, we fail to do it.” With Enron, Arthur Anderson, the Catholic church and U.S. intelligence agencies dominating the headlines for the past several months, the subject of ethics is in the American psyche more than at any time since Watergate. From the boardroom to the bedroom, the shredding machine to the spin machines of the power elite, whether in Rome, Houston, Boston or Washington, power still corrupts and absolute power still corrupts absolutely.

Of course, this is not only an American phenomenon. Webster University is, after all, a global community. We realize that in Britain, “the troubles” in Northern Ireland have raised ethical considerations for decades, the Swiss have had pressure within and without to reconsider their position of neutrality and, in reality, wherever Webster has a presence, there are people, and where there are people, there are ethical struggles. But it is not our ethics, but other people's ethics, or the lack of them, that most of us really like to talk about.

At arm’s length—or whatever the distance is between us and the CNN newsreader—it’s comfortable to wag a condemning finger at the powerful and their egregious abuses of power. But is it enough to look at these moral failures and ethical dilemmas as other people's problems? I think not.

“How do I exercise my power,” is a question that must be raised, and for that matter modeled, in every classroom from Little Rock to Leiden. Every teacher has power. Each campus director and administrator has power, too. And Webster students—individuals who will doubtlessly expand the scope of their power through their education—they, too, have power. We must look within. Here are a few suggested questions that could be a springboard, not just for discussion but for the kind of discussion that leads to growth and change.

• In my position, what are some ways in which I have power over others?
• What are real-world possibilities for me to abuse that power?
• What are some of the systems that are in place to protect against abuse of power?
• Am I doing as much as I should to let my students, co-workers, etc. know how to avail themselves of the systems that protect against abuse of power?
• Would it be useful to meet with these constituents to discuss the issue of abuse of power and ways to reduce its likelihood?

Do we know what the answers should be? I think I know what Grandpa would say.

Bruce Sogolow is the director of Webster's Sarasota Metropolitan Campus in Sarasota, Fla. He has also served at Webster's Albuquerque, N.M., and Lakeland, Fla., campuses as a faculty member, program mentor and community relations coordinator. He is the father of two adult sons who taught him ethics on a daily basis for many years.

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The MBA:

A Prescription for Success in the Health Care Industry

by James Georgoulakis

What is the largest industry in the United States? A couple of hints may help you figure it out. This industry consumes nearly 16 percent of the National Gross Domestic Product (GNP). One in eight American workers are employed by it. The costs to the consumer for services provided by this industry are rising at a double-digit rate and have been outpacing inflation for the past 10 years. The outlook for the future of the industry is for continued, accelerated growth. If you're thinking of computers or other types of technology, think again. This trillion dollar exploding industry is not computers, technology, manufacturing or defense-this industry is health care!

It wasn’t too long ago that the health care industry was populated by "mom and pop" operations. Television shows like “Marcus Welby, M.D.,” “Dr. Kildare” and the “Bob Newhart Show” all conveyed the message of a solo practitioner providing care unencumbered by a myriad of rules, regulations and statutes. Even more contemporary shows like “ER” fail to depict the “business” side of health care. While the provision of quality health care is undeniably critical, it’s often the business side of the industry that determines whether or not an individual health care provider or organization can remain viable.

The bottom line in health care is the same as any other business: the individual or organization must make a profit in order to continue to provide services. One often hears the chant that health care is a not-for-profit service. While it’s true that many of the nation’s finest health care facilities are non-profit organizations, the term not-for-profit refers only to how an organization distributes its profits, not whether an organization makes profit. All organizations—including health care organizations—must turn a profit to remain viable.

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How can health care providers and health care organizations remain viable in an environment that requires not only regulatory compliance, but fiscal knowledge and accountability, as well? Since each health care provider’s set of circumstances is unique, there are no guarantees for success. However, I believe that having health care providers possess MBAs is a step in the right direction. While I’m sure a number of directors of Health Care Administration graduate programs will take exception to my premise, to me the rationale for health care providers selecting the MBA over the MHA degree is simple.

Health care providers already have the background in health care—they have been and continue to be on the front lines of providing care. What they lack is knowledge of business, and this knowledge is best obtained through an MBA program. The MBA program contains coursework in areas such as accounting, finance, operations research and marketing-areas of knowledge that are essential for the success of any health care organization. Additionally, as more and more health care organizations become publicly owned, for-profit organizations, it’s critical that health care providers not only have a detailed understanding of how business operates, but can also speak the language of business.

While it’s not the intent of this article to debate the merits of one degree over another, it's becoming increasingly clear that tomorrow's health care environment will become more intertwined with the business world. As health care costs continue to rise and businesses are asked to foot more and more of the health care bill, it’s only natural that businesses will take a more active role in health care issues. Therefore, if the health care profession is going to continue to have a major impact on the direction of health care, it’s more likely to come through the contributions of health care providers who have also been trained in the business world.

James Georgoulakis, has a Ph.D. in psychology and a master's degree in business administration. He is a fellow of the American Psychological Association (APA) and is the APA's representative on the American Medical Association's Resource Value Update Committee (RUC). The RUC is responsible for recommending reimbursement rates for medical services provided under the Medicare Program. Dr. Georgoulakis has authored or co-authored four books and more than 75 publications. He is an adjunct professor at Webster's San Antonio campus.

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