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Medical Leadership : Doctors at the Helm Of CHANGE
Medical Leadership: Doctors at the Helm of Change
Nicholas Chadi*
Nicholas Chadi (M.D.C.M. 2012) has served as a junior editor for the MJM over the past year. He is currently a medical student at McGill University.
*To whom correspondence should be addressed: Nicholas Chadi, 441 Président Kennedy, Apt 1801, Montreal, QC, H3A 0A4, Email: nicholas.chadi@mail.mcgill.ca
This is an Open Access article distributed under the terms of the Creative Commons Attribution.
Introduction:
American and European medical treatments were generally provided by independent physicians who went from home to home to offer their services. From this form of medicine, often referred to as “bedside medicine”, (1) Western countries started to move towards a more centralized form of medical care provision: hospital medicine. During the 20th century, as cities steadily grew larger and more populated, numerous hospital supercomplexes with complicated hierarchal structures emerged. Employing hundreds and sometimes thousands of health care professionals, hospitals became increasingly difficult to manage and required the presence of a well organized management staff.
With the current aging of Western populations, developed countries now face major problems within their healthcare systems concerning economics and efficiency. Having to deal with the consequences of a strong movement of medicalization over the past few decades that has brought more and more elements of everyday life under medical jurisdiction, (2) Western governments are now struggling to restrain the rising costs of their national healthcare coverage. Seeking new venues and solutions, many countries like Canada allocate an increased importance to practices such as preventive medicine, surveillance medicine and homecare treatments. (1) All three of these practices tend to reduce the role played by hospitals in healthcare. However, hospital treatment remains an essential part of Western healthcare programs, and the development of parallel structures does not eliminate the management issues that health ministries are faced with.
Within hospitals and clinics, many aspects of the physician’s daily routine have changed dramatically during the past generation, adding another level of complexity to the management of healthcare. Both in Canada and abroad, doctors are increasingly unhappy with the way they are managed. A main cause of physician dissatisfaction lies in the fact that “the individual orientation that doctors were trained for does not fit with the demands of current healthcare systems.” (3) Faced with numerous problems like “funding constraints [and] demand[s] for greater accountability for the safety, the quality and the efficacy of healthcare,” (4) doctors are more and more frustrated with their daily workload and don’t feel as appreciated and supported as they might have been in the past. Physicians frequently receive instructions regarding these new demands from leaders who either do not possess a clinical background or do not wish to occupy the leadership role they are occupying. Hence, the lack of clear and reassuring guidance coming from respected and qualified professionals affects doctors as much as the overall well-being of the whole Canadian medical system.
“Medical leadership” has only recently started to take its place as a common medical term. As Dowton noticed four years ago, “leadership has received little attention in […] peer-reviewed medical literature.” (4) By definition, medical leadership consists of having fully trained physicians occupying leadership roles relevant to the practice of medicine. Physician leadership can include resource managing, decision making, recruiting and medical consulting as well as implementing changes and improvements in hospital and clinical settings (6). Medical leadership also goes alongside with adequate team building activities and an appropriate sharing of decision power. (7) In this perspective, there is no room for an all powerful CEO (Chief Executive Officer) having nothing in common with the team he is leading. On the contrary, good medical leadership intrinsically depends on the acknowledgement of the important role of all the levels of healthcare workers involved in the functioning of a hospital. (7)
Countries around the world are starting to realize the importance of good medical leadership. Although Canada is slowly starting to recognize the importance of training good medical leaders, other countries like the Netherlands, Denmark and especially the United Kingdom are a step ahead in initiating a wave of changes inside their respective healthcare systems (8). In Great Britain, the National Healthcare Services (NHS) is well aware of the importance of training competent medical leaders. For example, in a recent public report, J. Clark and C.M. Morgan, two physicians working at the NHS headquarters, wrote that the improvement of the British healthcare system through the successful implementation of current and future medical reforms “is very dependent on the support and active engagement of all doctors, not only in their practitioner activities but also in their managerial and leadership roles”. (9) Thus, British healthcare ministers understand that fully trained doctors must be involved in all the levels of the country’s medical structure in order for optimal changes to take place.
However, through the training they receive in medical school, doctors are taught to understand human nature like no other professionals. Considering this advantage, medical students should certainly be able to become both competent leaders and well estimated physicians if they are given the opportunity to develop the appropriate skills. Hence, if medical school applicants are to occupy leadership positions during their career, they must be chosen according to their leadership capacities. As for adequate leadership training, it must be integrated into medical curricula. Read More: for the ORIGINAL Unabridged article.
Last updated 849 days ago by JP Rajendran
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You get a world Picture in the above article, Have a look at the medical leadership in UK ( See Below) successive pages let us discuss the Leadership structures in India with special reference in Tamilnadu..
JP Rajendran 849 days ago