Hoff T J
School of Public Health, University at Albany, State University of New York, USA.
J Healthc Manag. 2001 Mar-Apr;46(2):91-109; discussion 110-1.
The growth of a medical management specialty is a significant event associated with managed care. Physician executives are lauded for their potential in bridging the clinical and managerial realms. They also serve as a countervailing force to help the medical profession and patients maintain a strong voice in healthcare decision making at the strategic level. However, little is known about their work loyalties. These attitudes are important to explore because they speak to whose interests physician executives consider and represent in their everyday management roles. If physician executives are to maximize their effectiveness in the healthcare workplace, both physicians and organizations must view them as credible sources of authority. This study examines organizational and professional commitment among a national sample of physician executives employed in managed care settings. Data used for the analysis come from a national survey conducted through the American College of Physician Executives in 1996. The findings support the notion that physician executives can and do express simultaneous loyalty to organizational and professional interests. This dual commitment is related to other work attitudes that contribute to success in the management role. In addition, it appears that situational factors increase the chances for dual commitment. These factors derive from a favorable work environment that includes both organizational and professional socialization in the management role. The results of the study are useful in specifying the training and socialization needs of physicians who wish to do management work. They also provide a rationale for collaboration between healthcare organizations and rank-and-file physicians aimed at cultivating physician executives who are credible leaders within the healthcare system.
医学管理专业的发展是与管理式医疗相关的一个重大事件。医师管理人员因其在弥合临床和管理领域之间的潜力而受到赞誉。他们还充当一种抗衡力量，以帮助医疗行业和患者在战略层面的医疗决策中保持强有力的话语权。然而，人们对他们的工作忠诚度知之甚少。探究这些态度很重要，因为它们关乎医师管理人员在日常管理角色中考虑和代表谁的利益。如果医师管理人员要在医疗工作场所发挥最大效力，医师和组织都必须将他们视为可靠的权威来源。本研究调查了在管理式医疗环境中工作的全国范围内的医师管理人员样本的组织承诺和职业承诺。用于分析的数据来自1996年通过美国医师管理人员学院进行的一项全国性调查。研究结果支持了这样一种观点，即医师管理人员能够且确实同时对组织利益和职业利益表达忠诚。这种双重承诺与有助于在管理角色中取得成功的其他工作态度相关。此外，似乎情境因素增加了双重承诺的可能性。这些因素源自一个有利的工作环境，其中包括在管理角色中的组织社会化和职业社会化。该研究结果有助于明确希望从事管理工作的医师的培训需求和社会化需求。它们还为医疗保健组织与普通医师之间的合作提供了理论依据，旨在培养在医疗保健系统中具有公信力的领导者的医师管理人员。
