Hailey Tran
There is an ongoing debate about whether hospitals should be run by doctors or business managers. While the conventional wisdom is that doctors should focus on patient care, some argue that doctors make better hospital leaders because of their extensive experience in healthcare settings and their ability to remain calm under pressure. A 2009 study found that only 235 out of nearly 6,500 hospitals in the United States are run by physician administrators. However, new research suggests that having a doctor in charge is associated with improved patient care and hospital quality. For example, the Mayo Clinic, where 80% of board seats are held by doctors, has been credited with its governance structure as one of the keys to its success. Surveys show that the majority of doctors believe they should make up the majority of hospital boards, indicating a dissatisfaction with the current state of hospital leadership.
| Characteristics | Values |
|---|---|
| Doctors make better hospital leaders | True in some cases |
| Doctors have more experience | True |
| Doctors are better at remaining calm under pressure | True in some cases |
| Doctors are better at communicating with a wide variety of people | True in some cases |
| Doctors are better at making quick decisions | True in some cases |
| Doctors are better at multitasking | True in some cases |
| Doctors are better at taking the long view | True in some cases |
| Doctors are costly | True |
| Doctors are in short supply | True |
| Doctors should focus on patient care | True in some cases |
| Managers with a business or administrative background are better suited to running the day-to-day operations of a hospital | True in some cases |
| Physician-run hospitals have higher quality scores | True in some cases |
| Clinically trained managers have higher management scores | True in some cases |
| Doctors should make up the majority of hospital boards | True in some cases |
Explore related products
What You'll Learn
Doctors make better hospital leaders
There is a perception that doctors make better hospital leaders than those with non-medical backgrounds. This perception is supported by a modest body of evidence, which suggests that including doctors on organisational governing boards improves performance. However, there is insufficient evidence to determine whether hospitals are unequivocally better led by doctors.
A 2017 article in Forbes, titled "Study Shows That Doctors Make Better Hospital Leaders", cites a Harvard Business Review article called "Why The Best Hospitals Are Managed by Doctors". The article highlights that physician-run hospitals in the US received higher quality scores than non-physician-run hospitals. It also mentions that hospitals in several countries with more clinically trained managers had significantly higher management scores. The article further discusses the importance of medical experience in hospital leadership, suggesting that physicians' ability to remain calm under pressure and make quick decisions with limited information are valuable leadership skills.
Another study by the NCBI, titled "Medical leadership: a systematic narrative review", supports the idea that doctors can bring valuable expertise to hospital leadership. The study found that a body of evidence suggests that including doctors on organisational governing boards improves performance and organisational outcomes. However, the study also acknowledges that there is a lack of empirical research directly comparing the performance of medical and non-medical managers.
While doctors may bring valuable skills and experience to hospital leadership, it is important to recognise that not all physicians are meant to be leaders. Leadership requires a diverse set of skills and qualities, and effective hospital leaders must understand the business side of healthcare and possess the right personalities and motivations. Additionally, it is essential to foster collaboration and mutual respect between doctors and other healthcare professionals, such as nurses, to ensure optimal patient care and organisational performance.
Hospitality Tax: Folly Beach's Extra Charge?
You may want to see also
Explore related products
Doctors should focus on patient care
While there are differing opinions on whether hospitals should be run by doctors or business managers, the conventional wisdom is that doctors should focus on patient care. This is supported by a 2009 study in the journal Academic Medicine, which found that only 235 out of nearly 6,500 hospitals in the United States are run by physician administrators. However, new research suggests that having doctors in leadership positions is linked to improved patient care and better hospitals overall.
Physicians have extensive experience in healthcare settings, which is invaluable for hospital leadership. They possess critical skills such as remaining calm under pressure, effective communication, quick decision-making, multitasking, and patience. These skills are honed through years of medical practice and are essential for providing quality patient care.
However, not all physicians are suited for leadership roles, and some may lack the necessary business acumen or have the wrong personalities and motivations for management. Additionally, the growth in hospital medicine has been associated with a decrease in the number of primary care physicians, leading to concerns about an adequate supply of PCPs.
Despite these considerations, many doctors advocate for their increased representation in hospital leadership. They argue that their presence in leadership positions ensures that patient care remains the top priority. For example, the renowned Mayo Clinic in Rochester, Minnesota, has 80% of its board seats held by doctors, significantly higher than the national average of 20%. Surveys consistently show that 90% of doctors believe they should constitute the majority of hospital boards, indicating a strong desire for change in how hospitals are run.
In conclusion, while doctors may not necessarily be suited to run hospitals, their presence in leadership positions is linked to improved patient care. Doctors bring valuable expertise and skills to hospital management, and their involvement ensures a patient-centric approach. Therefore, hospitals should strive for collaborative models where doctors work closely with administrators, fostering a climate of mutual respect and effective communication to ultimately enhance patient care.
Hospitals Hiring: Associate Degree Nurses Wanted?
You may want to see also
Explore related products
Nurses feel frustrated by rigid hospital hierarchies
While hospitals are often run by doctors, nurses play an equally crucial role in patient care. However, the presence of rigid hierarchies in hospitals can lead to frustration among nurses, who feel their professional worth is devalued. This frustration is not unique to nurses, as junior doctors in specialist training also experience similar sentiments due to the hierarchical structure.
Healthcare organisations are inherently hierarchical, with individuals ranked by authority or status based on factors such as profession, expertise, gender, or ethnicity. This hierarchy is often rigid, with leadership and decision-making concentrated at the top. In hospitals, this typically places physicians firmly in charge, despite nurses also offering expert advice on patient care.
The rigid hierarchy can hinder communication and collaboration between doctors and nurses, which is essential for effective patient care. It can also lead to power struggles and strong emotions of envy, rivalry, and victimisation. Additionally, nurses may feel they lack the mandate to make necessary changes to treatment processes, further contributing to their frustration.
To address these issues, some hospitals have adopted a flat hierarchy, which promotes flexibility, equality, and a supportive working environment. In these hospitals, nurses are more empowered to raise issues and concerns, delegate tasks, and ask for help. This approach has been associated with lower nurse burnout and job dissatisfaction, as well as improved patient outcomes and satisfaction.
Furthermore, the leadership style within a hierarchical structure can also impact nurse satisfaction. Transformational leadership, often associated with flatter hierarchies, has been found to positively influence the job satisfaction of nurses, leading to better nursing unit organisation culture and improved patient satisfaction and outcomes.
Funding Not-for-Profit Hospitals: Where Does the Money Come From?
You may want to see also
Explore related products
Physician-run hospitals top performance rankings
While there is a rigid hierarchy in hospitals that places physicians firmly in charge, nurses also play a crucial role in offering expert advice about patient care. In an interview for a vice president of nursing position at a community hospital, the chief hospitalist asked if nurses or doctors should be running hospitals. This question has been raised in the New England Journal of Medicine and remains a topic of discussion.
A study published in Social Science & Medicine found that physician-run hospitals topped the U.S. News and World Report rankings and earned approximately 25% higher quality scores than non-physician-run hospitals. James K. Stoller, Amanda Goodall, and Agnes Baker, who wrote for the Harvard Business Review, are not surprised by this finding. They argue that it is similar to trying to coach a team without ever having played the sport. Additionally, physicians have extensive experience in healthcare settings, which is invaluable for hospital leadership.
However, not all physicians are meant to be hospital leaders, and many do not aspire to take on such a role. To be a hospital leader, a physician must understand the business side of healthcare and possess the right personality and motivations. Some physicians may view running a hospital as an administrative task rather than a scholarly endeavour, while others may feel that assuming leadership responsibilities would compromise their clinical commitment.
In the Arab World, an empirical study examined the relationship between hospital rankings and whether they were headed by physician leaders or non-physician managers. The study found that Saudi Arabia had the highest number of top 50 hospitals, with 17 hospitals ranked in the top tier. However, Saudi Arabia also had the highest number of bottom 50 hospitals, with 7 hospitals ranked in the lowest tier.
While there are arguments for both sides, it is clear that the presence of physicians in leadership positions can positively impact hospital performance and patient care. U.S. News & World Report, for instance, evaluates and ranks hospitals based on various factors, including patient experience, survival rates, and expert opinions. These rankings help patients find the best hospitals for their specific needs, especially those with life-threatening or rare conditions requiring complex, high-risk treatments.
Genesys Hospital: Tubal Ligation Restrictions and Patient Rights
You may want to see also
Explore related products
Doctors want more leadership positions
Doctors are increasingly seeking leadership positions, and for good reason. The medical profession has witnessed significant changes over the past several decades, including the increasing reliance on molecular markers, the emergence of robotic surgery, healthcare reform legislation, and the extensive use of electronic medical records. Leadership is fundamental to the success of many fields, including medicine, and good leadership can have a positive influence on both patient outcomes and healthcare organizations.
A study published in Social Science & Medicine found that physician-run hospitals earned around 25% higher quality scores than non-physician-run hospitals. This is perhaps due to the extensive experience doctors have in healthcare settings, which cannot be learned from books or by observing others. They are trained to focus on the needs of each patient and adopt high personal standards, which can contribute to better leadership skills.
However, not all physicians are meant to be leaders, and some may not want to assume such roles. To be an effective leader, doctors must understand the business side of healthcare and possess good communication skills. They must also be able to make quick decisions with limited information, multitask, and remain calm under pressure.
Doctors are often not taught how to lead or rewarded for good leadership, and there is a lack of training and encouragement for those who aspire to leadership positions. This may be due to the traditional view of doctors as solely patient-focused and the stereotype that physicians are not meant to lead. However, with the right training and opportunities, doctors can become excellent leaders and bring about positive change in the healthcare industry.
Hospitals' HAI Data: Privacy or Public Safety?
You may want to see also
Frequently asked questions
No, among the nearly 6,500 hospitals in the United States, only 235 are run by physician administrators. However, new research suggests that having a doctor in charge is connected to overall better patient care and a better hospital.
Doctors have extensive experience in healthcare settings and possess leadership skills such as remaining calm under pressure, communicating with a wide range of people, multitasking, and making quick decisions. A study published in Social Science & Medicine found that hospitals with more clinically trained managers had significantly higher management scores.
Surveys of physicians routinely find that 90% of doctors think they should make up the majority of hospital boards.
The Mayo Clinic based in Rochester, Minnesota, is a world-renowned example. At the Mayo Clinic, 12 of the 15 board seats are held by doctors, which is 80% compared to the national average of 20%.
Doctors are in short supply and are costly. To be a hospital leader, a physician must also understand the business side of healthcare. Not all physicians are meant to be leaders, and some may have the wrong personalities or motivations.
