In transit from physician to manager--Part I

Physicians are finding themselves in increasing numbers in significant management roles. Physician managers interviewed about their experiences in changing careers identified six critical transitions, three involving psychological adjustments and three requiring development of new skills. A framework is developed in this two-part article that relates career events that trigger transitions, the transitions themselves, and the obstacles that can hinder or block success. The challenges that physicians encounter in management are similar to those faced by other professional groups, and the chances of successful transition can be improved by individual and organizational actions.     

In transit from physician to manager--Part II

In the March-April 1992 issue of Physician Executive, the authors described the six transitions that are required for a successful management career. In the second part of the two-part article, the authors describe some of the obstacles to successful transitions that were disclosed in their research.     

In pursuit of causality in leadership training research: A review and pragmatic recommendations

Although research shows a reliable association between leadership training and positive organizational outcomes, a range of research design issues mean we do not know to what degree the former causes the later. Accordingly, the paper has two main aims. First, to describe the conditions necessary to determine causality in leadership training research and the ability of different research designs to achieve this. Six important, but often ignored, issues associated with determining causality are described (control conditions, sample representation, condition randomization, condition independence, temporal design, and author involvement). Second, to review the extent to which the leadership training literature is able to demonstrate causality. The review shows that the majority of studies do not meet many of the criteria, even the most basic criteria, required to establish causality. Finally, we provide guidelines for designing future research to improve causal identification and is capable of generating meaningful theory and policy recommendations.     

A new tool for hospital/ physician strategic alignment: the subsidiary physician corporation

Physicians' and hospitals' strategies often diverge--with poor results for both. The causes of this divergence are many. They include different methods of payment, divisive governmental regulations (like Stark) and cultural differences.     

In search of American and British productivity and quality of organization

America and Britain have taken a long time to accept conceptually and pragmatically the post-war economic performance of Japan and other capitalist countries. Our understanding of how to improve our production infrastructure remains inadequate. This paper addresses the critical area of manufacturing organization and restructuring production operations to offer substantial and immediate results. Most of the resources required to become a world class manufacturer are already in place in the UK and the US, yet the organization of these resources remains lacking. The purpose of this paper is to review the importance of productivity and energy conversion within an integrated manufacturing strategy. Current differences in operations management thinking that exist between     

Two hospice patients and the roles of the physician and the physician executive

Hospice care is available nearly everywhere. Yet some physicians aren't aware of its role in end-of-life care. Explore what hospice care provides and how patients and their families may benefit.     

The Zen of physician initiatives

Many physicians today feel ravaged by the brutal speed with which change has been occurring. They see the beliefs and practices of a lifetime being abandoned and replaced by the flavor of the month, management du jour. But if you are willing and able to take the brave step of approaching your physicians without an agenda, meeting with them to listen to their concerns, and can also avoid hanging a lightning-rod label on every bright new idea that comes out of the sessions, you'll be on the way to effective new management. This new style is a "Zen" approach (but don't give it that label) that lets real collaboration come into the place that is supposed to be all about healing--the health care organization. From "never call it anything" to "stay with them until they get it," ideas on how to be a Zen manager are presented, with the ultimate goal of truly partnering with physicians and infusing them with a desire to move beyond the frustration and disenchantment they are feeling.     

Digital technology-based entrepreneurial pursuit of the marginalised communities

United Nations' Sustainable Development Goals call for an inclusive development and empowerment of marginalised communities. However, scholars have suggested that one single discipline or party, Multinational Enterprises, Governments or NGOs, cannot tackle these issues alone. Parallel to this, nonmarket strategies emphasising the societal context of economic competition have appeared as an important topic of research. Taking an inter-disciplinary perspective, this paper examines the extant research in digital technology, entrepreneurship and development studies to identify whether these three fields can help us understand how these issues can be tackled from a nonmarket strategies' approach and propose a conceptual model. We analyse papers published from 1994 to 2018 in these fields to map the collective state of research and provide a conceptual framework. We believe that this will help in establishing a relationship between digital technology, entrepreneurship and inclusive development. It will also help us to understand how to transform the benefits of technology into jobs and income for marginalised communities. This study will encourage researchers to investigate how United Nations' Sustainable Development Goals (SDGs) can be achieved.     

Increasing physician engagement. Using norms of physician culture to improve relationships with medical staff

Comments on the 2004 survey identified that physicians thought it was too early to judge whether the new structure itself was successful. This year, the survey will be repeated to measure the effectiveness of the new structure and to help administrators set goals to further improve physician engagement levels. Meanwhile, Mercy & Unity is using the tenets of the physician compact, elements of physician culture, and elements of administrative culture to inform new process-improvement activities. More study is needed to identify whether Mercy & Unity's techniques of reorganization contributed to the higher rates of physician satisfaction and engagement, but it is our belief that incorporating physician cultural norms into the process helped prevent the change process from turning the horse into the proverbial camel.     

The changing role of physician executives

Throughout the nation, physician executives are taking on new and emerging roles-from brokering the purchase of information systems and creating managed care networks to functioning as systemwide consultants, facilitators, and educators. This article offers profiles of eight creative physician executives-including their current roles and responsibilities, recommendations for emerging physician executives, and forecasts for the years ahead.     

The compensation of physician executives.

In January of this year, the American Academy of Medical Directors and the Physician Executive Management Center mailed a survey questionnaire to the approximately 2,300 members of the Academy of record at that time. More than 1,000 responses were returned. The purpose of the survey was to begin to collect data and establish a reliable baseline of compensation information for the physician executive profession. Subsequent annual surveys will allow the two organizations to track the course of the profession, insofar as this can be done on the basis of compensation. In this article, we provide a summary of some of the findings of the survey as they relate to physician executives in a variety of nongovernment health care settings. Except for the summary of overall data, the report is limited to the responses of physicians who indicated full-time involvement (75 percent or more) in management. Later this year, the complete findings of the survey will be published in a monograph that will be available from the Academy and Center.     

A behavioral profile of physician executives

In late 1993, ACPE and Tyler & Company, a national health care executive and physician search firm based in Atlanta, Ga., jointly conducted a survey of physician executives to determine their most likely behavioral patterns. It is the first of a two-part survey that, when complete, will create a multifaceted profile of the "ideal" physician executive as seen through physician executives' eyes and through the eyes of hospital management. Questionnaires based on the DiSC method of behavioral analysis were mailed to 750 randomly selected members of ACPE. More than 170 responses were received. The survey results showed that the majority of physician executives have strong communications skills, are people-oriented, and are strong leaders. The majority of respondents are self-motivated and industrious and are driven by accomplishments. The second part of the survey, which will be conducted later this year, will poll hospital CEOs and boards of directors about their preferences for behavioral patterns in their executives. Comparisons and consistencies will be analyzed between the two surveys to develop a comprehensive profile of the "ideal" physician executive, and the results will be reported in Physician Executive.     

基于组织结构的公共部门组织变革研究

通过组织变革来提高组织收益是公共部门机构改革的重要课题.已有文献表明,因为无法描述组织的结构特征和公共事务的差异性,组织变革的研究正面临瓶颈.本文根据公共事务发生地区性和职能性特征,构建了描述公共事务多重多任务特征的概率模型,用于分析公共部门的组织结构特征,并从组织收益提高视角研究了组织变革.研究结果表明,基于公共部门组织结构进行的组织变革可以明显提高组织收益.相关结果可以为公共部门的机构改革提供组织变革方面的参考.     

The making of a hospital physician executive

Physicians are accustomed to having the "buck" stop with them in the clinical arena. Indeed, they resist any attempt to have it otherwise. Management has only recently come back into their consciousness as a career possibility. Management is the "buck" that now belongs to the enemy, represented by managed care, paperwork, and regulation. The thoughts in this article have grown from the author's experience over the past six years as a physician executive in a community hospital, a career that followed 25 years in clinical and anatomical pathology.