Rethinking management

doi:10.1136/bmj.326.7382.221

BMJ 2003;326:221 ( 25 January )

Letters

Rethinking management

Fundamental rethink of medical management is needed

Changes seem to be ignored in health industry

Consistent criteria need to be applied to rationing decisions

I'm losing my religion

Fundamental rethink of medical management is needed

The first 150 words of the full text of this article appear below.

EDITOR $---$ Smith in his editorial on the rejection of the proposed consultant contract in England and Wales cites as a principalcause the widespread distrust among clinicians of hospital managers.¹In the same edition, Houghton et al identify a lack of adequatetraining in writing business plans, negotiating change, and gettingthings done as specific difficulties for newly appointed consultants.²

Clinicians are often thrust into senior management positions with major responsibilities for substantial budgets without thenecessary financial know-how. A fundamental rethink of medicalmanagement is called for. What is needed is the development ofa distinct career track in medical management at a much earlierstage, with the necessary management training on a par with thatavailable in the commercial sector. This model has worked wellin Australia. Such medical managerial posts will need adequatesessional commitments for these managers to provide a high qualityof executive function. . . . [Full text of this article]