Education And Debate

Mangement for Doctors: Doctors and management—why bother?

BMJ 1994; 309 doi: (Published 03 December 1994) Cite this as: BMJ 1994;309:1505
  1. Jenny Simpson, chief executivea
  1. a British Association of Medical Managers, Barnes Hospital, Cheadle, Cheshire SK8 2NY

    Case study

    In November the chief executive of St Christopher's, Mr Vincent, announced that the oncology ward would be closed for five months from the following week, for redecoration. Medical staff were outraged: this ward provided specialist oncology care for children from all over the region, and their parents gained a good deal of support from each other and from the medical staff. The oncology service had been built up over many years and provided specialist training courses for nursing and other staff. Patients were to be dispersed around the general wards and thus put at considerable risk of infection. Staff were also sure that the specialist nurses would find work in other oncology units so the hospital would lose its oncology nursing expertise.

    The consultants' anger was further fuelled by the fact that, on the face of things, doctors were being encouraged to take part in management, an involvement vociferously endorsed by the general manager. The hospital had a clinical directorate structure, but very little in the way of significant decisions seemed to be discussed at the clinical directors' meetings. The atmosphere had become increasingly sour over the previous two years, and several highly respected clinicians had left for posts in the pharmaceutical industry and abroad.

    The following week several consultants challenged Mr Vincent about his decision. He explained that he had taken advice from some senior key clinicians, but he refused to name them. This resulted in much speculation, suspicion, and ill feeling among the consultants. The nurses were also furious and felt that they had been betrayed by trusted colleagues. The atmosphere was extremely tense, and at the end of the week Dr Roberts called a meeting of the medical staff.

    At the meeting it transpired that no one had, in fact, advised Mr Vincent about the subject of …

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