If you’re such a good doctor, how come you want to be a manager?

2 03 2009

I remember being in Mr Gordon’s class aged 12 and telling both him and my peers that I wanted to be a doctor. I don’t know if I actually knew what that meant more than “helping people” but over the next 24 years I have struggled through Med School and the rigours of surgical training to reach my current position as a Consultant Surgeon. Within that role I have been steadily progressing for eight years. In all humility, I am actually quite good at what I do.

Why would I want to stop doing that and take on a role in management?confusion3

The dichotomy of clinician management is significant. Many clinicians feel that “management” are completely out of touch with the reality of medical practice and that this role is best filled by someone with knowledge of the discipline. The discipline of management, whether an art, a science or even a black art, is clearly not covered in any detail in the training and practice of medicine. It is similarly clear that clinicians cannot simply step from, say, an operating theatre, into a committee room and hope to practice with the same élan. If we require our management colleagues to be trained, then shouldn’t we as clinician managers match similar criteria?

Assuming this is resolved, there are many other significant issues to be dealt with. If management is so important, then it is also important to devote  appropriate quantities of time to the role. Relinquishing hard earned and valuable clinical skills seems iniquitous on both a personal and organisation level and yet neither tasks will be effectively carried out on a part-time basis.  Is it possible to be both clinician and manager?

Authority of this management role is neither implicit nor uniform. Often clinicians of lesser experience take on positions that are imbued with an authority that itself may not be respected or accorded by more senior colleagues. The history of  the clinician/management interface is one of many pitched battles, multiple casualties and much propaganda often the fault of the system rather than the protagonists. Students of management are clear that futile application of inappropriate strategies over the past decades has resulted in a deep mistrust that underpins many subsequent interactions. It is often held that the two sides actually have completely divergent aims and thus achieving a common purpose takes even more skill than would be required in a profit seeking organisation. Is it possible to undertake a role where the ultimate goals of the protagonists are so disparate?

It is clear that clinicians are required to be involved in clinical management and that to do so requires a commitment of training, time and loss of clinical skills. The task is rife with historical prejudice and the rewards are not clear. Why exactly would someone take on such a role?




7 responses

3 03 2009

Are you going to then? I think you’d be good at it.

3 03 2009

For what it’s worth:

Say an organization has 10% crap managers (many have a higher %). Organization may survive unscathed.
Suppose a hospital has 10% crap consultant surgeons ….
organization unlikely to escape unscathed; some patients highly likely to not survive at all?

Don’t quite know where this line of thought is taking me ..

3 03 2009

PPS: Just caught up with yr home page. Have you blogged about action research? What are your finding most valuable? What is getting to you as unexpectedly disappointing?

Is there much action learning through social networking going on?

9 03 2009
Anne Marie Cunningham

So are you doubting your decision to become a manager? I think combining a few things can be done. I am pretty certain that I am better as a part-time GP, and part-time educator/researcher, than I would be exclusively at either.

14 03 2009

I haven’t actually made the decision to become a manager yet one way or the other. My concern is that what I “do” will be affected by taking on that additional role. But if I don’t commit to that additional role is there any value in taking it on?

21 04 2009
Andy Press

I know a doctor who took on himself to started up, successfully a company that manage hospital’s emergency service. He was able to be successful partly due to his background as doctor of emergency.

21 04 2009

Thanks for the comment Andy.

Two points.

Firstly this would not (currently) happen in the UK where I practice and thus the aim of the company is to make money as well as deliver health care.

Secondly, I suspect that in performing this role, the physician would devote more of his personal efforts to running the company than performing medical duties.

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