Schneller E S
Director, School of Health Administration and Policy, College of Business, Arizona State University, Tempe 85287.
Hosp Health Serv Adm. 1991 Spring;36(1):43-55.
The emergence of managed care signals a need for an expanded role for physicians. Physician executives, trained in management, have the potential to become champions of clinical integrity, negotiators with patient agent organizations, public interpreters of hospital performance data, consultants to the profession, and designers of health care systems. Nonclinically trained administrators have been slow to recognize the unique skills and perspective that physicians bring to the managerial suite. The clash of professional and managerial cultures has often been perceived as precluding a strong working alliance between physician and nonphysician executives. As hospital margins are threatened, decision protocols must not be designed to incorporate teams of leaders who are able to overcome the managerial/clinical divide. The management of this interface will demand the attention of both administration and boards and may require the establishment of new structures in health care organizations.
管理式医疗的出现表明医生需要承担更广泛的角色。接受过管理培训的医生管理人员有潜力成为临床诚信的捍卫者、与患者代理组织的谈判者、医院绩效数据的公众解读者、行业顾问以及医疗保健系统的设计者。未经临床培训的管理人员一直未能充分认识到医生带入管理团队的独特技能和观点。专业文化与管理文化的冲突常常被认为会阻碍医生与非医生管理人员之间建立强大的工作联盟。随着医院利润受到威胁，决策流程的设计绝不能排除那些能够跨越管理/临床分歧的领导团队。对这一界面的管理将需要行政部门和董事会的关注，可能还需要在医疗保健组织中建立新的架构。
