The field of medical services is separated into two distinct categories: the public sector, financed through tax dollars; and the private sector, financed through patient fees and charitable donations. Public and private sector purchasing systems have very significant differences and often require workers with different backgrounds and personality types.
PRIVATE MEDICAL SERVICES
The Nature of the Work
The purchasing department in a private institution is usually responsible to the chief financial or administrative officer, and, unless the institution is part of a medical care system or chain, the departmental policies and procedures are developed by the purchasing department subject to the approval of the administrative head. This relative autonomy allows the department considerable flexibility in the development of systems designed to meet the special needs of the institution. Purchasing is considered to be a support service and, therefore, plays an important part in both operational planning and expansion of facilities or services planning. Purchasing is involved in the acquisition of highly complex medical equipment which is often experimental in nature.
The purchasing department is usually responsible for the procurement of all support materials and equipment, furniture, landscaping equipment and supplies, custodial equipment and supplies, and office equipment, which may also include highly sophisticated computer hardware and software. The department is sometimes also responsible for food service and pharmaceuticals, although, in most cases, these items are specified and ordered by the dietary department and the pharmacy. The purchasing systems most often used are the open market quotation and the informal bid procedure.
Considering the nature of the organization, it is not surprising that availability and delivery service is a major factor when selecting vendors. Many of the products and services purchased are vital in life or death situations, and inventory control is especially sensitive to medical requirements. Most medical institutions also have elaborate product and service evaluation systems to ensure that the items meet rigid quality standards. These evaluation or quality control committees also play an important part in developing specifications and standards for new products and equipment since the purchasing department cannot be expected to know all of the medical implications.
Product knowledge is, however, extremely important in the medical field, and it is knowledge that can be gained only through experience. Therefore, it is not unusual for people entering the medical purchasing field to come from some of the technical areas or from complex clerical positions. Although most purchasing officials recommend a degree in business as desirable, the primary emphasis is on product knowledge and a thorough familiarity with medical organizations and their needs. Many of the products are obtained through long-term contracts. Consequently, skill in negotiating is an important asset. As in most other industries, a member of the purchasing staff is involved with every planning and evaluation committee and must be able to work effectively with a cross section of the medical community.
Working conditions vary. Many newer institutions are spacious and well equipped. In some older institutions, the purchasing department, along with other office staff, is often crammed into whatever space is available, as the size of the staff and the patient load far exceed capacity. The pay scale is average for the industry but below the average of purchasing positions in unrelated industries. Fringe benefits are good, and job stability and security are above average. Opportunities for advancement seem promising as the medical and health fields continue to expand at a rapid rate. The working environment is fast paced because of the number and variety of products and services involved, and the life-or-death element does create a sense of urgency. The need for accuracy and detail is extremely high, as is the need for continuous follow-through. The work group is diverse and interesting because of the variety of professions involved in the day-to-day activities. Most institutions are highly structured and organized with well-defined priorities. Opportunities to use purchasing as a stepping-stone to higher management positions that require a different set of skills are limited. Directors of purchasing are seldom appointed to chief of surgery, for example.
Personnel directors expect candidates for purchasing positions to have strong personal goals and, as one purchasing manager stated, be mission oriented. They must be emotionally stable with a cheerful outgoing personality, adaptive, innovative, and able to grasp complex concepts quickly. Since confidentiality is often required, they must have good judgment and high ethical standards. They are often the link between a demanding user and the supplier, a situation that requires strong interpersonal relationship and mediation skills.
Also, many purchasing professionals in this field have an exceptionally strong sense of commitment. They are all very much aware of the stakes involved and believe that they are an essential part of a team effort in the delivery of quality health care.
PUBLIC MEDICAL SERVICES
The Nature of the Work
The principal difference between public and private medical service workers is not what they do but how they do it. Since public medical institutions are usually an agency of a state, municipal, or federal government, much of the purchasing is done by some government central purchasing department. However, depending on the special nature of the institution's mission, government control over public institutions, purchasing policies, and procedures differs dramatically. In some cases, the institution is allowed to purchase completely outside the government's system. In other cases, the purchasing function may be shared based on dollar limits or product categories, while in still other instances, the responsibility for purchasing policies and procedures may be vested entirely with the central government. Under-standing the nature of the relationship between the government and the institution is extremely important if you are considering a position in this field because the nature of the relationship determines both the experience needed and the personality type best suited for the position.
In situations in which the institution has almost complete autonomy, the determination of policy and procedures is very similar to the private institution, except that the system is probably subject to audit by the government purchasing or general accounting office. This state of relative autonomy really means that the purchasing department may design a purchasing system, including open-market quotations that will best meet its needs. As long as the system is fair and allows tax-paying suppliers to compete, it will be allowed to continue.
The other extreme is the total control of the purchasing function by the government agency. In this situation, the purchasing department's function, at the institutional level, is primarily a clerical link. Although needs assessment is accomplished at the local level, and, in some cases, some of the specifications may be developed locally, the buying process is handled by the government central purchasing department.
Entry Requirements and Qualifications
Entry-level positions vary. Since employment is usually subject to civil service regulations, positions in purchasing are filled according to those policies. If the institution is unionized, then additional requirements may be imposed. You should visit the employment office of the local government and obtain as much information as possible about hiring and promotional practices. Then visit the purchasing office for further information concerning procedures and policies at the local or institutional level. You should be able to determine the degree of autonomy that the purchasing department has in developing its own policies and procedures which, in turn, will tell you much about job responsibilities and conditions.
This information is so important because, ultimately, working in a bureaucracy demands a certain type of personality. If you function best within a highly structured environment and enjoy following an established routine and rigid guidelines, then working in the public sector might be best for you in terms of job satisfaction.
The desired personality and character traits are basically the same as in the private sector. You must be emotionally stable, not easily frustrated, and have a good sense of organization. You will be required to interact with many departments and, depending on the internal structure, with the centralized purchasing department. Therefore, excellent verbal and written skills are absolutely essential. As stated before, public institutions usually operate accord ing to very rigid purchasing procedures as a matter of public policy. Therefore, attention to detail and strict guidelines is also essential.
Compensation will probably be higher than the private sector. Fringe benefits are excellent, and civil service employment does offer considerable job security. Working conditions and surrounding facilities vary greatly. Some of the newer institutions have modem equipment and facilities, while many of the older ones show the effects of years of operating on less than adequate budgets.