Education And Debate

Management for Doctors: Getting started as a medical manager

BMJ 1994; 309 doi: (Published 10 December 1994) Cite this as: BMJ 1994;309:1563
  1. J F Riordan, executive medical directora,
  2. Jenny Simpson, chief executiveb
  1. a Central Middlesex NHS Trust Hospital, London NW10 7NS
  2. b British Association of Medical Managers, Barnes Hospital, Cheadle, Cheshire SK8 2NY

    Getting started as a medical manager

    Case study

    Three years after his appointment as a consultant physician, Dr B was persuaded by his colleagues to become chairman of the cogwheel division of medicine, all the other physicians having taken their turn. He coped easily with running the monthly divisional meeting, found some satisfaction in juggling the junior medical rotas, and saw his most challenging role as resisting the attempts of the surgeons to “protect” their beds.

    After a year in post a keen new general manager was appointed to take the hospital into trust status; he selected Dr B with several other consultants, not all of whom were divisional chairs, to form a management board. Dr B became the first clinical director of medicine. Initially he found this difficult as his colleagues continued to run the old divisional structure in parallel with the new arrangements. Also the senior nurses in medicine were suspicious of medical involvement in their management.

    After some months of regular meetings with the nurse manager, along with several training and team building sessions, Dr B found that by working as part of a team he could influence the functioning of the medical service and achieved a number of successes. These included improving the process of case note retrieval; rearranging the appointments procedure; and developing a number of enthusiastic teams to take on specific projects within the directorate. After a few months the atmosphere and communication within the directorate had improved considerably, with staff of all grades beginning to contribute their ideas and support for the new systems. On the strength of this, Dr B managed to persuade his consultant colleagues to disband the cogwheel division and set up a full directorate structure with a number of subdirectorates. To his surprise he found that he enjoyed working with some of the newly recruited, bright, and …

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