‘Why be a manager when you’re a hospital doctor?’ Researchers ask—and answer

Almost every hospital and health system has some number of physicians who take on mid- or high-level administrative duties. But the published literature is scarce on which factors tend to facilitate—or discourage—outstanding candidates who might pursue and/or accept such roles. 

Researchers at Laval University in Quebec City have worked to fill in some of the blanks. The result is a conference paper published in an ebook titled Operations Research and Artificial Intelligence in Healthcare Management.

For their study, corresponding author Célia Lemaire, PhD, and colleagues systematically reviewed 26 published studies. They sought to identify factors that tend to lead physicians to take on managerial roles over and above their regularly expected duties.  

The team also looked at the influence of support from hospital leadership—or the lack thereof—in moving physicians into roles as managers, directors and senior-level leaders. 

Their actionable findings include the following three. 

1. Physician involvement in the day-to-day management of clinical activities depends on a number of factors.

“Adequate organizational support, a clear definition of the role, autonomy, authority and appropriate resources are essential to facilitate physician-manager involvement in their role,” Lemaire and co-authors report. 

They present a table summarizing common incentives and disincentives. 

2. Expectations of physician-managers are both reasonable and unsurprising. 

Anticipated additions include regular meetings, a “less distant” attitude, an effective and visible presence within the organization, opportunities to share their experience and expertise, and a chance to exercise their authority in difficult situations.

“Clinicians involved in management are also asked to impose restrictions on the provision of care and services to meet the organization's financial imperatives,” the authors observe. “In addition, they are asked to engage in teamwork, demonstrate communication skills, develop emotional intelligence and business acumen.” 

3. The literature suggests a number of corrective measures to encourage physician involvement in the management of clinical activities.

Lemaire and colleagues group these under three main headings:

• Structuring the physician-manager role and providing the necessary resources.
   
• Recruiting physicians with a natural aptitude for management.
   
• Establishing a culture that encourages the emergence of physician-managers.

“By implementing these changes, organizations can contribute to the emergence of a new culture in which doctors are more willing to take on leadership roles and become actively involved in hospital management,” the authors write. 

Their complete findings, they add, should be of interest to those setting career-management policies within healthcare organizations and those involved in the academic training of physicians.

The ebook is available for downloading in its entirety here.