For Partners, some surgical precision in achieving efficiency is a good thing

As detailed in the Globe, Partners HealthCare is addressing thorny questions on the relationships between its premier hospitals, Massachusetts General and Brigham and Women’s (“In name, Partners; in practice, still unclear,” Page A1, Feb. 5). Better integration has appeal, but implementation creates issues. World-class general hospitals must offer full ranges of standard and innovative services. And competition can lead to more options for patients.

Elsewhere, forced integration has precipitated losses of talent. Partners has allowed its components considerable independence, while looking for ways to integrate operations, especially administrative and clerical functions, that would not disadvantage either hospitals or patients.


In this regard, it should be noted that the US health care system stands out for its extraordinarily high administrative costs compared with other developed countries. More reduction of these costs could save substantial amounts of money for clinical staffing, provision of care, and medical innovation.

Medical treatment is front-line work, provided by staff close to the delivery of care. The fewer levels of staff between the clinician and the chief administrators the better. More clinical staff — that is, “duplication” of medical talent — may be a good thing. It is duplication of support services that is inefficient and unnecessarily costly. Perhaps Partners got that right.

Dr. Bruce M. Cohen


The writer is director of the program for neuropsychiatric research at McLean Hospital, where he is the former psychiatrist in chief, and is a professor of psychiatry at Harvard Medical School. McLean is in the Partners system.