Physician as managers - Dissertation Example

? Physician as managers Recently different health care organizations around the world focus their policies on development of managerial practices among physicians. A model of physician dominance is substituted by the dominance of managers. Professional management is one of the most important elements for physicians to reach success in the hospitals. The main two elements in professional management in healthcare system are: knowledge and skills. The American healthcare system makes an emphasis on the necessity to promote managerial skills among physicians. The study evaluates the roles of physicians in the American healthcare system and determines future environment for determination of management practices development for physicians in the country. Keywords: Managerial roles, physician manager, hospital management. Introduction There are numerous challenges in healthcare system in America nowadays. To deal with inefficient hospital services, it is necessary to take measures at governmental and local levels. The American hospitals are on their way to achievement hospital autonomy and reorganization of healthcare system in the country. The main role of a physician extends the limits of a person, who is responsible for healthcare, but he becomes a person responsible for management of his activities in his daily professional practice. The most triggering underpinning of the study theme is the President’s policy in the sphere of medicine and health care. Thus, on June 15, 2009 President Barack Obama appealed for the American Medical Association with the necessity to cooperate with physicians in the name of a mutual development of a new reform. Physicians are presented as the most reliable partners on the way to reform introduction and health-care services should be more individually oriented and outcome-oriented. There is a need for a constant support of the patients; sensitivity of the physicians to their patients is one of the utmost concerns. Quality of medical care in America should be above financial gains. Statement of the problem A public role of physician has always been neglected in this country. The same can be said about the necessity to develop managerial skills among the physicians. Medical services for underinsured or uninsured people remain a challenging issue. There is a need for fair distribution of financial resources in health care system. Moreover, the usage of cost-effectiveness data should be guided by the physicians. Unfortunately, very often physicians remain indifferent toward this policy. The new role of physicians is more integrative and sound than it used to be. The research paper determines to what extent modern physicians deal with managerial skills; whether development of cost-effectiveness data usage and management determines the degree of health effectiveness and physicians’ practice. Methodology It is suggested to apply qualitative and quantitative approaches in this study. The grounded theory approach implies research development in the process of data collection and analysis. From a wide range of qualitative approaches, correlational approach is chosen. The dependent variable of physicians as managers is measured in such a way. Confidential questionnaires will be filled in by the physicians 65 years of age or younger from different specialties for exploration of their attitude to their new roles as leaders and managers. It is suggested that the respondents would indicate their agreement or disagreement on the basis of the following research questions: “To what extent modern physicians deal with managerial skills,” “Whether development of cost-effectiveness data usage and management determines the degree of health effectiveness and physicians’ practice.” In accordance with potential answers, physicians will be classified as “conservative,” “moderate,” or “liberal” on “managerial and social issues”; individual and demographic characteristics (age, sex, race, and region); and their clinical specialty will be the basis for calculation of the quantitative data on physicians’ readiness to develop their managerial skills. Moreover, it is expected to correlate qualitative data with the governmental policies of health reform. The President and his government claim that the involvement of physicians in social and managerial practices covers the scope of their responsibilities (Form and Reform 2009, p. 89). Therefore, there is a clear attempt to unite different skills and experiences of different physicians in the name of a common goal. In terms of the second underpinning of the research, which is the World Health Report 2006 in which effective workforce policies were promoted, the following objectives are outlined: (a) to evaluate the management roles of American physicians based on available data, (b) to determine potential new roles of physicians for the future environment, (c) to develop the critical points and considerations for the future challenges of the physician managers in America and (d ) to outline further perspectives of the study. Theoretical framework The hospitals have always been positioned as ‘dual hierarchies’ in which medical staff and the administrative staff did not play a determinant role in the process of treatment. Physicians and hospital managers collaborated in the name of effective decisions in the treatment process. Inability of the modern physicians to follow their managerial obligations is considered to be beyond the scope of their responsibilities and roles. The modern physicians are able to manage their daily tasks and perform their activities more efficiently in case of obtained managerial skills, such as time management, information processing about patients etc. On the one hand, the introduction of managerial roles for the physicians can evoke numerous conflicts, such as balancing clinical, teaching, research, and management roles (Gorin, 2010). Managerial skills development implies numerous costs, a potential hazard of low quality and productivity, ineffective resources usage and challenging strategies. Consequently, to prevent financial and human resource waste, there is a need to develop hospital efficiency. We can see on the example of recent studies and researches that Healthcare managers are mainly challenged by the problem of financial improvement in the hospitals. There are three background factors influencing the necessity of triggering managerial practices among physicians. The first factor is the need for changes in the public expectations of their healthcare services. The second factor underlines the necessity to introduce changes in technology, improve clinical knowledge and cooperation between managers and health care workforce. The third factor is the global trends in the development of healthcare service sector, such as societal changes, financial pressures, internationalization of healthcare systems, the necessity to integrate into global market for research and development (Buchmueller & Monheit, 2009). Therefore, it should be noted that there are numerous changes in the modern positioning of physician as a good manager. There are different changes at the strategic decision level. In the hospitals very often middle and top managers are more powerful than physicians. Currently Physician management is now on the border with hospital management. In the modern dynamic healthcare environment, physicians play dual roles: of a professional manager and of a professional physician. At the local level there is a need to finely balance these two skills and obligations. The physicians take part in the strategic decision-making and the hospital performance is associated with their ability to perform the role of professional managers. There is a mixture of managerial abilities and skills within the modern physicians. For example, managerial jobs comprise a wide range of knowledge, skills, behaviors, and attitudes (Duboi&McKee, 2006). Healthcare management implies the presence of many other practices, uniting clinical and healthcare knowledge (Form&Reform, 2010). On the basis of the famous works on management and the roles developed for physicians as managers, it is possible to outline the most demanding roles: Mintzberg’s model (e.g., leader, monitor, negotiator, etcetera), Zuckerman and Dowling’s model (strategist, leader, designer), Quinn model (e.g., facilitator, innovator, coordinator, etc.) and Guo’s model (strategist, communicator, delegator). Within the scope of these managerial roles models it is possible to outline potential abilities of physicians at work. For example, in accordance with Mintzberg’s model, it is necessary to develop leadership, monitoring and communicative skills (Mintzberg, 1998). Significance of the study On the basis of the considered concept paper it is clear that the future of American physicians will be different in comparison to what they have nowadays (Smith, 2011). 1. It is claimed that modern physicians should be more individually oriented, keep in mind social and managerial issues of their activities if they are looking for career promotion; 2. Physicians should be able to show their managerial skills and for this purpose they should keep in mind their professional development as managers and physicians; 3. There is a need to differentiate between top management positions and keep physicians beyond these responsibilities. In other words, every physician should have an opportunity to occupy leading management position in case he has obtained required managerial skills and knowledge (Lieble&McConnell, 2004). 4. Very often management skills are not taken into account when a physician is appointed for the higher-rank position. Therefore, it is relevant to take into account not only medical reputation or the years of service, but also management skills. 5. There is a need to introduce an obligatory graduate education on business administration. On the example of the Czech Republic, Hungary and Poland, physicians are enrolled in hospital management programs to advance their professional performance. 6. Top management positions in the hospitals should be available for physicians in case they have graduated from the professional trainings or educational programs in the Universities. 7. A challenging perspective of this study implies the necessity to correlate the relation between the organizational size and the workload to outline the number of physicians, who are potentially able to occupy higher-rank positions at the hospitals (Rechel&Pillay, 2008). Therefore, the options of positioning healthcare services as "Managed Care" implies introduction of standard management norms and rules in the field of healthcare system. There is a need to eradicate the physicians from the worn-out context of the Old World order. In other words, very often physicians live in their own artificially-created world, where their lives are prestigious, special and they live autonomously. Medicine of the 21st century triggers different mechanisms of physicians’ functioning. The American health-care delivery system needs physician-managers. The role of this new coming profession can be explained by the processes of unity and integration, which happen in different fields of human activity and globalization processes. Moreover, another context of newly introduced changes is explained in terms of health-care management, which shifted to another level. Earlier, it was mentioned that health-care management occurs on an individual basis that is within a hospital, a health-care center, pharmaceutical factory, ambulatory surgery center and hospice (Abernetty, 2008). Currently, there is a need to choose level of management practices of physicians, which will lead to the most perfect outcomes of treatment. To reach high quality of health-care services and decrease cost spent on health-care system, it is relevant to introduce the profession of the physician-manager. Nowadays it is possible to position the physician-manager as a professional caregiver and a professional manager, who is able to reach maximum effectiveness of his job at the least costs (Mahon & Young, 2006). It is clearly seen that the intention of the modern American health-care system to combine clinical and management training implies the creation of a new effective profession in the field of medicine. The question about cost and quality of the newly envisaged profession remains open. A modern physician faces with a challenge: to accept or not to accept the social changes triggered by the new health-care reform; to manage or not to manage health-care services in the 21st century (Kisa & Ersoy, 2005). Therefore, it is evident that the modern paradigm of health-care in America is changing. Under conditions of the new health-care reform, the physicians of the country are challenged by making the choice of the most appropriate policies and strategies of realization of their managerial potential. There is a need to increase professional awareness of physicians in the field of management in order to prepare high-quality candidates for top management. Not only medical experience of work or long years of work in the field of medicine should be taken into account by the modern physicians, but also their professional management skills and abilities. The major drawback for the modern physicians is the absence of professional training in the field of management. The management skills are often obtained by the physicians in the process of their job, but they are rarely occupied in professional trainings or programs in this field. With regards to the necessity to advance managerial skills among the physicians, training in management for physicians is one of the most crucial concerns in the modern field of medicine. The perspective of this study is to determine management skills required for the modern American physicians, determine potential opportunities of seminars, or short courses, which would identify the physician's management style and the best forms of its realization; reveal to what extent modern physicians deal with managerial skills, determine whether development of cost-effectiveness data usage and management determines the degree of health effectiveness and physicians’ practice.Moreover, under conditions of globalization, the trends of holistic approach in different practices of human activities concern the field of medicine as well. 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