Intended for healthcare professionals


What doctors and managers can learn from each other

BMJ 2003; 326 doi: (Published 22 March 2003) Cite this as: BMJ 2003;326:610

A lot

  1. Richard Smith, editor (
  1. BMJ

    Doctors and managers have different cultures, which opens up possibilities not only of fruitless fighting but also of rich learning. I've belonged to both cultures. In 1989 I went to the Stanford Business School in California with a typical doctor's view of management: boring, uncreative, and best left to those incapable of doing anything better. I came back thinking the opposite. To be able to mix together ideas, people, and resources to makes things happen is creative, difficult, and a privilege. Generally, there is even more uncertainty in management than medicine. Having now inhabited both cultures it's clear that they have much to learn from each other—and where better to do that than within healthcare systems, where they work alongside each other?

    Not everything is different between the two cultures. Both professions are full of highly committed people who work extremely hard—often to the point of damaging themselves and their families. The training of both is long, hard, and never ends. Contrary to what doctors may believe, managers think about ethics. Shocked by the scandals of the 1980s, business schools have been teaching ethics for as long as medical schools. This is not to say that all managers behave ethically any more than all doctors do.

    Both professions respond to financial incentives. Doctors like to fool themselves that they don't, but there is overwhelming evidence that they do—just like everybody …

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