Clinician managers: back in vogue

Abstract

The NHS must train more clinician managers. It was a historic mistake to create a manager class who were not doctors. These are not the words of a royal society, medical college or the British Medical Association. No, these are the musings of Jeremy Hunt, Secretary of State for Health, towards the end of a year that he spent bashing doctors. For once, Mr Hunt has a point. Less so in relation to his questioning of non-clinical managers. Management is a skill that isn't taught at medical school, developed during clinical training or well established among doctors. Hence, when the NHS needed managers, it looked elsewhere. Why not turn to the professionals? Now, of course, the quality of managers varies as widely as does the quality of doctors, but career managers working in the NHS face the same impossible calculus that clinicians do: how to deliver a satisfactory service in an age of rising demand and austere funding. On this latter issue, Mr Hunt combined his carrot towards clinician managers at an NHS Providers conference with a stick to beat delegates who had called for increased funding for the NHS. In Mr Hunt's mind, the NHS has received more money than other government departments and that means people working in the NHS should be satisfied. Clearly, more money doesn't mean enough money, but Mr Hunt thinks it does, especially when he still believes that efficiency savings are realistic. In healthcare, take revalidation as another example, the current focus is on the stick rather than the carrot. 1 Where Mr Hunt does have a point is in his call for more clinician managers, both doctors and nurses.

UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

“… 2 Health care is a diverse, complex, and unpredictable field which is often best appreciated and understood by clinicians who have direct hands-on experience of patient care. 3 There is mounting evidence that those making managerial decisions within a clinical setting should possess clinical, managerial, and leadership skills. 4 , 5 A strong favorable association has been shown between clinician Chief Executive Officers and the quality of a hospital resulting in positive implications on financial resources, quality of care provided, and hospital social performance.…”

Medical Students’ perceptions and attitudes toward Medical Leadership and Management

“…Healthcare is a diverse, complicated, and unpredictable field that is often better conducted by clinicians who have direct practical experience in patient care. 3 Growing evidence now indicates that managerial decisions are being made by clinicians in whom managerial and leadership skills are commonly present. 4 Clinical expertise and hospital performance have shown a strong association and have improved the financial, quality of care, and social performance in hospitals.…”