Excellent article from Paul Levy at Beth Israel in Boston, who takes the time to explain the budget process at a hospital. The last paragraph says it all, ask questions and comment. Doctors are busy doing their jobs, research doing the same and sometimes are not aware of potential budget restraints or on the other hand perhaps some additional budget enhancements that could be available. 
Setting the budget and forecasting is one tough job no matter how you cut it. If you are working in a hospital and want some insight as to the areas covered and an overview of the process, it's worth reading and explains quite a bit. As everything else goes in the world today with being more complicated, the same holds true for hospital budgets, and there's always the unexpected to deal with as well, no matter how well forecasting is done, there always appears to be something that may require funding that was not in the initial budget, and it could appear in any of the sectors mentioned. A new law or rule that goes in to effect during the year that was not available for consideration at budget time is a simple example. BD
I don't think that anything I have said here is new or controversial among hospital administrators or their Boards. However, it has become clear to me that many of these concepts are outside of the realm of experience of many hospital doctors, scientists, and other staff. If you are reading this and it is new or strange to you, please comment. If you are reading this and are involved in hospital management or governance and have something to add or subtract, please comment, too.
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