Doctor-managers as decision makers in hospitals and health centres

• Published in: Journal of health organization and management Vol. 20; no. 2; pp. 85 - 94
• Main Authors: Elina, Viitanen, Juhani, Lehto, Tiina, Tampsi-Jarvala, Kari, Mattila, Irma, Virjo, Mauri, Isokoski, Harri, Hyppölä, Esko, Kumpusalo, Hannu, Halila, Santero, Kujala, Jukka, Vänskä
• Format: Journal Article
• Language: English
• Published: England Emerald Group Publishing Limited 01.03.2006
• Subjects: Accountability; Adult; Attitude of Health Personnel; Clinics; Decision making; Decision Making, Organizational; Doctors; Education, Medical, Graduate; Efficiency; Expenditures; Female; Finland; Focus Groups; Health administration; Health care policy; Health facilities; Health services; Hospital Administration; Hospital-Physician Relations; Hospitals; Humans; Knowledge; Line managers; Male; Managers; Medical practices; Middle Aged; Physician Executives - education; Physician Executives - organization & administration; Physician Executives - standards; Physicians; Power; Primary Health Care - organization & administration; Professional Competence; Professional identity; Professionals; Reforms; School principals; Specialized services; Studies; Surveys and Questionnaires; Finland; Health services; Decision making; Finland; Doctors
• ISSN: 1477-7266; 1758-7247
• DOI: 10.1108/14777260610661493

Purpose - This paper describes factors influencing doctor-managers' decision making in specialised health care, health centres and at different levels of management.Design methodology approach - Data were collected as part of a survey on physicians graduating in 1977-1991 as drawn from the register of the Finnish Medical Association. The study sample was formed by selecting all physicians born on odd days (n=4,144) from the baseline group (n=8,232). The category of doctor-managers comprised physicians reporting as their main occupation: principal or assistant principal physician of hospital, medical director or principal physician of health centre, senior ward physician of hospital, and health centre physician in charge of a population area.Findings - Independent of gender, all doctor-managers responding to the survey reported that the most important base for decision making was personal professional experience. Position in organisation (first-line manager, principal physician) had no impact on the base of decision making. Doctor-managers in primary health care utilised knowledge on norms and knowledge available from their organisation in support of their decision making to a greater degree compared with doctor-managers in specialised health care.Research implications - Evolution discourse from public administration is not yet receiving much response in Finnish doctor-managers' activities, instead, they still act as clinicians.Originality value - Facing the growing challenges of the future, the paper shows that doctor-managers should reconstruct their orientation and to act more like managers.