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COMMENT: Should Hospital Administrators Hold MBAs or Medical Degrees?

Private and public healthcare spending has steadily increased every year since the mid-1990s. Good management in the healthcare sector is more than a fi...

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|Jul 1|magazine7 min read

Private and public healthcare spending has steadily increased every year since the mid-1990’s.  Good management in the healthcare sector is more than a financial matter, as patient health and satisfaction are the true measure of performance.  Still, effective hospital leadership that oversees all dimensions of patient care is central to sustainability.

Senior managers within the industry face the challenge of overseeing growing and increasingly sophisticated businesses.  Many leaders also face the challenge of bringing a different set of skills to the position.  In British Columbia, about half of hospital CEOs are physicians who became managers well into their careers.  These individuals know the industry from a physician’s standpoint but sometimes lack the business sense required of management.  Conversely, individuals with education and experience in business management often lack medical expertise.  Who, then, is the ideal candidate to lead a hospital? 

Daniel Skarlicki, professor of organizational behavior at the University of British Columbia’s Sauder School of Business, commented on the conundrum by saying, “Canadian physicians are great physicians, but they’ve had very little exposure and training in how to run the business side well.  They need to understand operations, IT, personnel and budgeting issues. I’m not just talking about the CEO; the head of surgery is running a business, too. And that’s what we’re trying to do here: to introduce some of the ‘state of the science’ of business acumen into health care.”

The qualities that make up a great clinician are different from those that make up effective leaders and managers.  The required knowledge and worldview differ between the two professions.  Clinicians are primarily concerned with their patients, and when they move to a management position, they are required to take in a broader scope.  Managers who do not come from a clinical background many only have the bottom line in mind, leading to reluctance to prioritize patient care.

A hospital-administration model called co-management is becoming increasingly common in Canada.  Co-management involves physician leaders overseeing and directing clinical elements of management in partnership with non-physicians whose extensive business education and experience give them an advantage in the non-clinical side of the business.  This seems to be the ideal pairing, and it may be the future of the industry.

Cameron Love, executive vice-president and chief operating officer of The Ottawa Hospital, believes that the qualities essential to good leadership depend less upon educational backgrounds and more on actual abilities.  Love recently told the Financial Post, “You can have the brightest people in the world who are poor leaders, and then there are people who become leaders with no formal training because they lead very well. MD’s bring a good knowledge base to health care, but I think we’re going to see more leaders who don’t come from a clinical background.”  Perhaps together, knowledgeable clinicians and savvy business professionals can provide today’s hospitals with the experience and expertise they need in order operate as smoothly and productively as possible.