Medical managers in contemporary healthcare organisations: a consideration of the literature

Abstract

To consider the literature supporting the evolution of the roles of a Medical Manager within contemporary healthcare organisations. Consideration of available literature. Limited dedicated literature available. Consideration of available studies and expert opinion reveals benefit of doctors in management positions within healthcare organisations. The roles of Medical Managers arise from: organisational structure-theory of healthcare's 'professional bureaucracy'; clinical directorate models; clinical governance, legislative and public health requirements; and the duality of combining medical knowledge with business and healthcare management training. Roles identified are: (1) leadership and management of medical staff including appointments and credentialing, and mentoring of medical staff in Clinical Directorate roles; (2) strategy development including Medical Advisory Role to Executive; (3) clinical governance including quality and risk management and legislative requirements; and (4) operational areas that benefit from clinical and management skills. Strengths of this review include considering contexts of Medical Managers in medical and healthcare management literature. Weaknesses include drawing inferences from theory. Future recommendations include formal studies and systematic reviews of available literature of the subject. In light of falling Medical Management trainee numbers, this study highlights the value to the health system of a dwindling Medical Management profession, the urgent need to encourage more medical practitioners into management and for organisations to further embrace Medical Managers in key leadership roles.