In a recent NY Times op-ed, Sandeep Jauhar uses the internecine struggles of a small California hospital to suggest that our health system would be improved if more physicians held executive leadership positions at our nation’s hospitals. (Shouldn’t Doctors Control Hospital Care?). Certainly, doctors and nurses should control providing medical services to patients. These professionals have years of training and experience in making these important decisions.
However, the skills needed to provide administrative leadership for hospitals are significantly different from those needed to provide clinical care. Modern hospital leadership requires excellence in understanding community needs, human resources, accounting, finance, economics, logistics, and government regulation. Without skilled administrators who have mastered these and other elements, physicians would not be able to focus on patients.
This distinction between clinical and administrative leadership is not new. Florence Nightingale implemented administrative processes, financial management, medical records systems, and architectural standards for hospitals beginning in 1854. Today, most hospitals in the US are not-for-profit institutions, led by the combined expertise of their medical staffs, administrators, and boards of community leaders. For all the challenges and changes in healthcare over the last 150 years, this model has proven very successful.
Dr. Jauhar might have focused on the many physicians who pursue advanced education in healthcare and business administration. These physicians often do bring a unique and powerful perspective toward the business of healthcare. But suggesting that our health system would be improved if only more doctors were in charge is simply not supported by the facts, and it disparages the many dedicated and talented healthcare administrators who are as committed as any physician to the health of patients and communities.
Anthony Stanowski, DHA, FACHE
President and CEO
Gerald L. Glandon, PhD
President and CEO
Association of University Programs in Healthcare Administration