In the battle against the COVID-19 epidemic, Wuhan Central Hospital has suffered the most infections among its staff and paid the highest price, becoming the epicenter of the epidemic.
In just one month, Wuhan Central Hospital has lost four outstanding doctors: Li Wenliang, Mei Zhongming, Jiang Xueqing, and Zhu Heping.
According to reports from The Paper, Hu Weifeng, the deputy director of the Department of Urology, and Yi Fan, the deputy director of the Department of Cardiothoracic Surgery, are still in critical condition. Wang Ping, the deputy director of the hospital, has also been infected and is in serious condition.
In fact, all hospitals in Wuhan have experienced healthcare worker infections, but why has Wuhan Central Hospital suffered the most?
The reason behind this is that Wuhan Central Hospital, originally a medical institution, has become heavily bureaucratic and administrative. This has led to administrative power suppressing professional authority and administrative leaders taming professional talents, resulting in a lack of preparedness and high costs in the face of the epidemic.
Wuhan Central Hospital's surface problems reflect a more widespread phenomenon: the bureaucratization and administrativeization of organizations, where non-experts lead experts.
It can be said that Wuhan Central Hospital is just a typical example of a bureaucratic scientific, educational, and medical institution.
Non-experts leading experts
The primary function of a hospital is to save lives. The most important personnel in a hospital are clinical doctors.
Let's first look at the director of Wuhan Central Hospital, Peng Yixiang. Although she has a medical background, her work after graduation has had little to do with clinical practice.
According to information, after graduating, Peng Yixiang worked in the education department of Tongji Medical College of Huazhong University of Science and Technology for a long time. From July 1992, she worked in the teaching office of Peking Union Medical College Hospital as a student counselor, academic officer, and clinical medical teaching management staff. From August 2007, she started working in student ideological and political education management and actively promoted the reform of medical students' extracurricular activities.
Peng Yixiang is also a bureaucrat, but looking at the papers she has published, they mainly focus on hospital management and medical education, without involving clinical content.
All of this shows that Peng Yixiang is just a bureaucrat with a medical background but no medical practice.
Therefore, the real leader of Wuhan Central Hospital is not Director Peng Yixiang, but Secretary Cai Li.
According to a statement from an emergency department surgeon in the hospital, although Director Peng Yixiang lacks work experience, she at least comes from the medical system. However, Cai Li, coming from the health administrative department, is even further removed from the frontline of clinical practice and does not truly understand the operation of the hospital.
During a visit to the emergency department, Cai Li requested that respiratory patients be brought over, even though it was the winter season with fewer trauma patients. This resulted in a cross-infection between respiratory and trauma patients, with patients recovering from fractures but then contracting pneumonia.
This lack of expertise leading expertise inevitably leads to a phenomenon where non-experts pretend to be experts and make arbitrary decisions. The key issue is that these non-experts hold high positions in the organization and have the power to give orders, which must be followed.
Therefore, when the virus began to wreak havoc in Wuhan Central Hospital, the result of various chaos was that the epidemic began to spread uncontrollably, and the first to be infected on a large scale were healthcare workers.
Administrative power suppressing professional authority
In some positions, as long as one knows how to be an official, they can get by. They may even be considered outstanding officials if they write good reports.
However, in professional and technical units, there are two different logics. The career path for professional and technical personnel is based on their own professional and technical development, while the career path for administrative positions is based on their own promotion.
Therefore, the inherent conflict is that an administrative official is unlikely to gain genuine respect and recognition from a professional and technical person if they lack professional and technical abilities and skills. On the other hand, administrative officials look down on the rigidity of professionals.
However, the resources of an organization are under the control of administrative officials. Therefore, in professional and technical units, the correct management model is generally expert governance. Leaders should emerge from experts, which is conducive to the inheritance and development of professional skills, and professional and technical personnel are more likely to respect such leaders.
But looking at Wuhan Central Hospital, both the secretary and the director were appointed from outside the hospital, and they lack professional and technical abilities. They came to lead the hospital without realizing the inherent tension within the organization.
The leaders think, "You healthcare workers may not respect me or obey me, but I will make you respect me and obey me." Healthcare workers think, "You may just be a bureaucrat, you don't understand, so you should be humble and stop giving orders."
The result at Wuhan Central Hospital is that administrative power has clearly suppressed professional authority. Whether facing Ai Fen, who blew the whistle, or Li Wenliang, who warned about the virus, the administrative department did not consider right or wrong, but rather reprimanded the doctors from an administrative standpoint.
They may not understand the hospital's operations, but they have the authority to manage and even reprimand these professional and technical personnel, causing them immense psychological pressure. Ai Fen, a professor, was reprimanded and even told her husband to take care of their child. One can imagine the severity of the reprimand and the pressure she faced.
In fact, according to many doctors, they are already busy with their professional duties, but they have to attend endless meetings, take endless notes, and deal with non-professional matters that keep them busy. A significant amount of their time is occupied by administrative tasks rather than professional ones.
This trend has also been criticized by employees in similar units.
The administrativeization of professional and technical units is becoming more and more prominent, with professional and technical personnel being checked, assessed, compared, and assigned more and more.
In some cases, the evaluation of a professional and technical person is not based on their professional and technical abilities but on their non-professional performance!
The prevalence of bureaucratic formalism
A professional and technical person who has been away from their professional position for a long time may also fall into the trap of bureaucratic errors. And an official who is not from a professional and technical background and becomes a leader in a professional and technical unit will exhibit even more severe bureaucratic tendencies.
Bureaucracy is characterized by valuing hierarchy over practicality and truthfulness. During the outbreak of the epidemic, it was clear that there was a significant amount of human-to-human transmission, and the entire hospital staff was already anxious. However, the hospital followed the strict order to keep everything confidential and threatened doctors who leaked information.
Before Li Wenliang was reprimanded, he had already been severely criticized by the hospital. Ai Fen, the head of the emergency department and a professor and graduate supervisor, could not escape being belittled.
"In mid-January, everyone was covering up the truth. From the provincial level to the city level to the hospital level, the province did not allow the city to report, the city did not allow the hospital to report, and the hospital did not allow the departments to report. This led to the missed golden period of prevention and control," a doctor from Wuhan Central Hospital told Caixin reporters.
Bureaucracy is also evident in the disregard for the suffering and safety of employees. They are afraid of leaders who act like gods but fear leaders who act like pigs. These leaders not only follow orders but also prevent doctors from taking self-protective actions.
At the beginning of the outbreak, Wuhan Central Hospital, in the face of shortages, refused personal donations of alcohol, citing inconsistent donation standards and unwillingness to take risks, and asked each department to contact donors individually.
A doctor said that in early February, someone contacted Wuhan Central Hospital and offered to donate half a ton of rice. A driver went to the hospital, but the donation was rejected by the management because the hospital strictly followed the Red Cross regulations for all material donations.
Employees criticized the management for not sounding the alarm in a timely manner and not ensuring the safety of the hospital. They failed to control the virus but could have controlled the protection of healthcare workers. They lacked responsibility and accountability.
Bureaucracy is also evident in arbitrary decision-making. Democratic and scientific decision-making, often mentioned in the 1990s, was disregarded here, and decisions were made unilaterally by the leaders. During the outbreak at Wuhan Central Hospital, the opinions of professional personnel, who should have been listened to the most, were reprimanded, warned, and excluded from the decision-making process.
Bureaucracy is evident in the retreat and shifting of blame after things worsen. Wuhan Central Hospital had a large number of doctors infected, and the healthcare workers on the frontlines were physically and mentally exhausted. However, there was no sign of the leadership's direct command and coordination, nor any care shown to the frontlines.
Formalism is the aftermath of bureaucracy. When you visit Wuhan Central Hospital's website, you will see formalism everywhere, evident in their self-promotion. Because they only know how to be officials and not how to do professional work, they have to put on a show.
Lack of respect for knowledge and talent
Promoting the development of science and education is the country's strategy, as emphasized by Comrade Deng Xiaoping: respect knowledge and respect talent.
In particular, the medical system, as a self-growing system, needs a large number of cases and accumulated experience to transform into a medical advantage.
The growth history of a doctor is a long and gradual accumulation of time. It takes 14 years to become a attending physician: five years of undergraduate study, three years of master's study, three years of doctoral study, three years of standardized training, the attending physician exam, and research funding. To become a chief physician, it takes at least another ten years of hard work. This kind of professional advancement and dedication should be respected and recognized.
However, under the rough administrative management and strict control measures at Wuhan Central Hospital, doctors have to be cautious, obedient, and follow orders, suppressing their well-rounded talent and knowledge, and their knowledge cannot give them dignity.
During a hospital meeting in the early stages of the epidemic, some senior doctors wearing masks were criticized for "not understanding medical common sense and scaring people." It was clearly the leaders who lacked medical common sense, and it was clearly the management's lack of concern for the physical and mental health of healthcare workers.
In bureaucratized organizations, the normal relationship between leaders and employees becomes distorted, and the roles of service and being served are reversed.
In this case, Wuhan Central Hospital tragically fought against the epidemic almost nakedly. The hospital management did not coordinate and plan ahead, leading to healthcare workers having to modify medical waste bags and make makeshift protective clothing. Many employees did not receive proper protection and had to hastily respond to the situation.
And when they reprimanded Li Wenliang and Ai Fen, there was no respect for knowledge and talent, and the expected human care was lacking. Management became a matter of exercising power, and regulatory departments were arrogant and haughty, tightly controlling behavior.
For many years, a social problem that has been criticized is the rampant bureaucratization, leading to those who do not understand teaching becoming school principals, those who do not know how to treat patients becoming hospital directors, and those who do not know how to conduct research becoming institute directors. Those who know how to be officials become leaders who know how to get things done.
Of course, many outstanding leaders have emerged from this system. That is because they follow the operating rules of professional and technical units, respect knowledge and talent, and strive to resist the administrative and bureaucratic tendencies of the organization.
However, Wuhan Central Hospital clearly did not achieve this, resulting in arbitrary commands, disorderly operations, and heavy casualties in the face of the epidemic. Unintentionally, they have become a typical example of a bureaucratic scientific, educational, and medical institution.