Fitzgerald L, Sturt J
Warwick Business School.
Health Serv Manage Res. 1992 Jul;5(2):137-46. doi: 10.1177/095148489200500206.
This article examines the issue of drawing medical consultants into managerial decision making. It commences by examining both historically and comparatively the influences on doctors and their reluctance to adopt managerial roles and responsibilities. It progresses to an analysis of the impact of the NHS and Community Care Act particularly in relation to the separation of purchaser and providers and the development of contracting mechanisms. The argument presented suggests that the rapid adoption of the clinical directorate model, as the favoured mode of organisation in acute units, has led to clinicians assuming 'imitation' general manager roles. The authors question whether this is the best use of the unique skills and time of clinicians. They compare with experience in the USA and propose that collaborative working between doctors and general managers is essential in health care. The article suggests a set of tasks for clinician managers and then discusses the issues of training support and development which will be required if clinicians are to perform these tasks effectively.
本文探讨了让医学顾问参与管理决策的问题。文章开篇从历史和比较的角度审视了对医生的影响以及他们不愿承担管理角色和职责的情况。接着分析了《国民健康服务与社区护理法案》的影响，特别是在采购方与供应方分离以及合同机制发展方面的影响。文中提出的观点表明，作为急症科室首选组织模式的临床主任模式的迅速采用，已导致临床医生承担起“模仿”总经理的角色。作者质疑这是否是对临床医生独特技能和时间的最佳利用方式。他们与美国的经验进行了比较，并提出医生与总经理之间的协作对于医疗保健至关重要。本文为临床医生管理者提出了一系列任务，然后讨论了如果临床医生要有效执行这些任务所需的培训支持与发展问题。
