CASE STUDY: CLINICIAN TO MANAGERS

Case Study: Clinician to Managers



Case Study: Clinician to Managers

Introduction

Organizations are complex entities, often difficult to understand. Many factors make organizational life complicated, ambiguous, and unpredictable. The biggest challenge for managers and leaders is to find the right way to frame our organizations in a world that has become more global, competitive, and turbulent. The book by Bolman and Deal is a marvelous work on understanding how organizations function. It also provides practical suggestions for reframing organizations in order to adapt them better to current business realities. Bolman and Deal focus on both management and leadership. The authors believe that organizations face several dangers. If, for example, an organization is overmanaged but underled, it will eventually lose any kind of sense of purpose and spirit. On the other hand, a poorly managed organization with a strong and charismatic leader may soar briefly only to experience a significant downfall shortly thereafter. Bolman and Deal suggest that we need today more people in managerial roles who can deal with organizational confusion and chaos by establishing order and finding simplicity; we need managers who love their work and organizations, and respect the people whose lives they affect. Leaders should be both artists and analysts, who are flexible and versatile enough to reframe their experience, as well as constantly seek new issues and discover possibilities. The authors also suggest that leaders and managers should view management more as a moral and ethical undertaking and should attempt to combine business realism with a passionate commitment to larger values and purposes(Friedson, 1987, pp. 140).

The case: From Clinician to Manager

There are those who advocate that the solution to the many dilemmas like the ones mentioned in the case can be solved by having a medically qualified professional administrators, not in clinical practice, forming the basis of hospital administration. In turn, this has ensured that there is no alignment of responsibility and accountibility, and hence authority, at the level where critical decisions are made, where contact is closest with clients and cost containment is the most difficult to achieve. Ideally, this arrangement only works well when there are no financial constraints and the provision of any given clinical service is limited only by the capacity or commitment of the clinicians concerned to provide it.  

Rationing of services is now a fact of everyday medical life and clinicians are implicated in these processes whether they participate in them in a managerial capacity or not. Arguably, if clinical freedom is to be maintained and maximised, and doctors are to remain the advocates for their patients, it is imperative that they become involved in the process of resource allocation and its responsible management. In common with other professional groups in the public sector, clinicians are having to confront a number of vexing and potentially threatening issues affecting the governance of their organisations and the work they do. With the growth of professional management groups (or administrators) in the public sector, at least three issues have become particularly pressing for professionals such as clinicians. First, professional managers are becoming an increasingly powerful group who can significantly impact on the ways other professionals perform their work and make decisions about resource ...