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Putting the Ethics Back into Healthcare Compliance

ethics4We all know someone who is a pest, a professional colleague, a friend or even a family member. I use the term affectionately and especially when I write postings that are restatements of obvious points.

In the healthcare compliance field, it is striking how compliance is often defined by only the term “compliance.” Where in the world is the term “ethics”?

If there is an industry where consumers, i.e. patients, deserve to see the term “ethics,” it should be in the healthcare industry. It is time for ethics to be added to the equation.

CCOs in the healthcare industry need to be elevated and empowered. They have the title, they lack the resources, and they need to have a message of support sent. The board of directors and senior management can use the designation of the CCO as the Chief Ethics and Compliance Officer.

I know that it makes the CCO’s title a little more complex, changing from a CCO to a CECO is never an easy transition but symbols can have powerful results. We all know that symbolic actions can have a more dramatic impact than actual actions. Politics is often just the management of symbols and messaging. Some even argue that great leaders are masters of using symbols to communicate important messages that influence behaviors.

The same goes for the transformation of the CCO to a CECO. The change in title can have two dramatic results.

First, and most importantly, it is a great way to begin the transformation of an organization’s commitment from a culture of compliance to a culture of ethics. We all know that an ethical culture is much more than a compliance culture. By injecting ethics into the behavioral question, managers and employees at an organization will have to ask the question – “Is this right?” instead of “Is this legal?”ethics3

An ethical culture is much more valuable to an organization than a culture tied to questions of legal compliance. A commitment to ethics, if embraced by an organization, will improve overall financial performance, productivity and ultimately adherence to the law.

Second, the elevation of a CCO to a CECO empowers the CECO within the organization and sends a powerful message of the organization’s commitment to an ethical culture. Too often, CCOs in the healthcare industry have been relegated to backwater offices, even while they were separated out of the legal function in the organization. Separation, however, did not mean empowerment.

Healthcare organizations have to realize that compliance is fast-changing and CCOs need to become part of the C-Suite and overall business strategy. Compliance is not just a cost center; it is an important way to enhance the organization’s financial performance and reputational integrity.

ethics2Starting in the 1990s, HHS and regulators sought to promote compliance by mandating that organizations separate the legal and compliance functions. HHS believed that there was an inherent conflict between legal and compliance and that the separation of the two functions was necessary to protect the integrity of healthcare organizations.

Whether or not there is such a conflict, that issue can be debated. More importantly, the issue of separation is justified by a separate consideration – legal and compliance have very different missions and need to be separated to ensure that each function is managed and staffed effectively.   The healthcare industry embraced the separation of the CCO and the legal function but it failed to recognize the importance of elevating and empowering the CCO. That is the challenge the industry faces today.

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