A central motif of health reforms around the world is the push to get doctors and other clinical professionals more actively engaged in the management of services. Examples include moves to extend the commissioning role of primary care doctors (such as general practitioners in the UK) and the introduction of ‘clinical directorates’ in secondary care. In some respects these trends mark an increasing convergence in policy and practice between national health systems. The clinical director model, for example, was first pioneered in the US (at the John Hopkins Hospital in the 1980s) and later copied in the UK, Canada, Italy, Norway and, most recently, France. However, while there are strong indications that healthcare management has become an “international fashion” caution is required. Existing comparative research points to “distinctive national or regional variants” in the way health management reforms have been introduced. In this paper we address this matter by suggesting a framework for making international comparisons. After defining what we mean by the development of clinical management roles, we outline a model, which proposes that this process is likely to be mediated by three significant variables. Implications for future research is addressed.
The Development of Medical Manager Roles in European Health Systems: A Framework for Comparison
LEGA, FEDERICO;
2011
Abstract
A central motif of health reforms around the world is the push to get doctors and other clinical professionals more actively engaged in the management of services. Examples include moves to extend the commissioning role of primary care doctors (such as general practitioners in the UK) and the introduction of ‘clinical directorates’ in secondary care. In some respects these trends mark an increasing convergence in policy and practice between national health systems. The clinical director model, for example, was first pioneered in the US (at the John Hopkins Hospital in the 1980s) and later copied in the UK, Canada, Italy, Norway and, most recently, France. However, while there are strong indications that healthcare management has become an “international fashion” caution is required. Existing comparative research points to “distinctive national or regional variants” in the way health management reforms have been introduced. In this paper we address this matter by suggesting a framework for making international comparisons. After defining what we mean by the development of clinical management roles, we outline a model, which proposes that this process is likely to be mediated by three significant variables. Implications for future research is addressed.
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