Developing health care management skills in times of crisis: A review from Baltic region

Abstract

Health care is now under pressure to change related to new situations in demand side (demographics, pattern of diseases, public expectations), supply side (technology and clinical knowledge, health care workforce), and wider societal changes (financial pressure, internationalization of health care systems, global market for research and development). The increase of health expenditure in most of the middle- and high-income countries exceeds GDP growth rate and threatens further competitive capacity of economies tight in bearing the burden of social costs. A period of economic slowdown is challenging for health care systems in many countries. It is also the case for countries in Baltic region now looking for ways to bring more value for money spent on health care. Several factors are listed as causes for rising health care costs. Some of them (e.g. aging and unhealthy lifestyles of individuals) are out of the sphere of direct influence of doctors, managers of health care organizations, and even ministries of health. However, other causes (e.g. introduction of new costly technologies, utilization of expensive medications, organization of care processes) are in their direct domain. There is growing evidence that organizations will benefit from additional non-clinical competencies acquired by doctors – the key persons in control of resources in health care. The goal of the study is to evaluate current practice of medical education in several universities of different countries regarding amount and content of courses aimed to develop contextual organizational, leadership, and management competencies. The study is based on analysis of content of selected undergraduate studies of medicine programs in all three Baltic countries and other selected countries in Europe. The results of this study showed wide variation in the defining courses aimed to develop non-technical core competencies and the lack of dedicated courses for developing elements of entrepreneurship in most of the analyzed programs. This study demonstrates the lack of collaboration that exists between governments, health providers, and universities with regard to adaptation of professional education programs to the needs of changing health care systems. The author suggests that further research is needed to prove the hypothesis that integration of entrepreneurship, economics, and management education into curricula of medical studies will add the systemic view and inter-professional competencies needed by all future physicians and will support development of leadership of tomorrow's health care managers.