Intended for healthcare professionals

Education And Debate

Doctors and managers need to speak a common language

BMJ 2003; 326 doi: (Published 22 March 2003) Cite this as: BMJ 2003;326:655
  1. Rifat A Atun, director (
  1. Centre for Health Management, The Business School, Imperial College London, London SW7 2PG

    Changes in the NHS since the 1980s have resulted in a systematic shift of control away from clinicians to managers. This has led to a doctor-manager divide and an unhealthy “them and us” culture. Unsystematic efforts to bridge this divide have had limited success. New approaches are therefore necessary.

    Most doctors have little involvement in management, perceiving that it conflicts with professional duties and adds unnecessary work. Those who are willing to participate are prevented by a lack of formal management training. The most important barrier is …

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