Schwartz R W, Pogge C
Department of Surgery, College of Medicine, University of Kentucky Chandler Medical Center, Lexington, Kentucky, USA.
Am J Surg. 2000 Jun;179(6):462-8. doi: 10.1016/s0002-9610(00)00395-0.
Academic medical centers (AMCs) face severe financial constraints because they must now compete directly with private providers that focus exclusively on cost-effective healthcare delivery. Educational and research capacities developed at AMCs have been supported by government and third party payers, but government support is diminishing. Physicians are ill-equipped to respond to market pressures.
Analyses of cultural change and restructuring in corporate giants such as Greyhound, IBM and FedEx are relevant to teaching hospitals. To succeed, organizations must flatten hierarchy, empower staff, train leaders, and mobilize intellectual capital. Effective leadership is essential.
Physicians must educate themselves on forces impacting the AMC, understand changes needed in the structure and processes of AMC governance and acquire competencies for leadership and management if AMCs are to survive and thrive. Surgeons should acquire competencies that will enable them to become leaders in the process of AMC transformation.
学术医疗中心(AMC)面临严峻的财务限制,因为它们现在必须直接与专注于成本效益高的医疗服务提供的私立医疗机构竞争。AMC所发展的教育和研究能力一直得到政府和第三方支付方的支持,但政府支持正在减少。医生应对市场压力的能力不足。
对灰狗、IBM和联邦快递等企业巨头的文化变革和重组分析与教学医院相关。为取得成功,组织必须扁平化层级、赋予员工权力、培养领导者并调动智力资本。有效的领导力至关重要。
如果AMC要生存和繁荣,医生必须了解影响AMC的各种力量,理解AMC治理结构和流程所需的变革,并获得领导和管理能力。外科医生应获得能使他们在AMC转型过程中成为领导者的能力。