Experience of domestic and foreign healthcare by appointment of specialists without medical education to the head positions of medical institutions (literature review)

Abstract

Following the special attention of foreign colleagues to appoint doctors as hospital managers, the issue 
 of appointing specialists without medical education to the management of medical institutions in Russia is increasingly being looked at and discussed. 
 The purpose of the study is to analyze historical and modern literary sources that highlight the experience of domestic and foreign healthcare by appointing specialists without medical education to the head positions of treatment and preventive medical institutions.
 The analysis of literary sources from 1940 to 2021 was carried out in electronic scientific libraries: Scopus, Web of Science, MedLine, eLibrary, CyberLeninka, Central scientific medical library and the Russian State Library by keywords: manager, physician, physician leadership, hospital CEO
 The article presents historical data on the formation in Russia since the beginning of the 18th century of the first medical institutions for the needs of the army and navy and the appointment of doctors to senior positions in them. From 1755 to 1908, the management of military hospitals was temporarily transferred to specialists without medical education, which led to numerous conflicts and a decrease in the efficiency of hospitals. Currently, in a number of foreign countries, in order to improve the quality of medical care, the issue of transferring managerial functions to doctors in hospitals is being actively discussed.
 The main reasons for the discussion about the expediency of appointing specialists to senior positions in medical institutions without medical education are: shorter terms of their training; health care activities in market conditions; the need for modern managers to possess leadership, managerial, economic and legal competencies.
 Conclusion. The work experience of domestic and foreign health care indicates the expediency of appointing doctors with leadership qualities and special training in the field of healthcare institutions and public health to senior positions in medical institutions. This contributes to the formation of a corporate culture in medical teams and improving the quality of medical care for the population.