Edited by Myron D. Fottler, Donna Malvey and Donna J. Slovensky
Chapter 17: Managing clinical professionals
Managing clinical professionals is a daunting task for any healthcare manager in the United States. The management of clinical professionals is a required healthcare administration competency made more complicated by contentious historical relationships, conflicting belief systems, competing values, employment trends, and policy influences. Historically, US physicians made clinical determinations (for example, diagnosis and treatment), commanded the resources to carry out the task (for example, prescribing) and directed how other caregivers’ work would be performed (for example, issued orders). This is no longer the case. Ideological, economic, political, clinical, technical, and organizational change, occurring within a framework that is moving from provider-driven to buyer-driven care environments, all influence the care management. Authority for clinical responsibilities has devolved and extends to a variety of professions in recent years, with more change yet to come. Further, the expectation placed on the entirety of the healthcare system to provide high-quality care has created an implicit interdependency that can both strengthen and weaken the system’s ability to provide that care. This chapter will explore these issues to provide insight about the challenges of managing clinical professionals. The chapter first explains the cultural dynamics associated with medical professions to provide some context for how clinicians view management.
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