Future of medical engagement
Helen Dickinson A E , Marie Bismark B , Grant Phelps C and Erwin Loh DA Melbourne School of Government, The University of Melbourne, Vic. 3052, Australia.
B School of Population and Global Health, The University of Melbourne, Rm 442, Level 4, 207 Bouverie Street, Carlton, Vic. 3010, Australia. Email: mbismark@unimelb.edu.au
C Deakin University Medical School, Geelong, Vic. 3220, Australia. Email: g.phelps@deakin.edu.au
D School of Public Health and Preventive Medicine/School of Clinical Sciences at Monash Health, Monash University, 246 Clayton Road, Clayton, Vic. 3168, Australia. Email: Erwin.loh@monash.edu
E Corresponding author. Email: helen.dickinson@unimelb.edu.au
Australian Health Review 40(4) 443-446 https://doi.org/10.1071/AH14204
Submitted: 28 October 2014 Accepted: 17 August 2014 Published: 21 September 2015
Abstract
Although it has long been recognised that doctors play a crucial role in the effectiveness and efficiency of health organisations, patient experience and clinical outcomes, over the past 20 years the topic of medical engagement has started to garner significant international attention. Australia currently lags behind other countries in its heedfulness to, and evidence base for, medical engagement. This Perspective piece explores the link between medical engagement and health system performance and identifies some key questions that need to be addressed in Australia if we are to drive more effective engagement.
References
[1] Berwick D. Eleven worthy aims of clinical leadership of health system reform. JAMA 1994; 272 797–802.| Eleven worthy aims of clinical leadership of health system reform.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2czlvV2lsA%3D%3D&md5=8fb39b8fe6820bc07ad5411152d6cc29CAS | 8078145PubMed |
[2] Jiang HJ, Lockee C, Bass K, Fraser I. Board oversight of quality: any differences in process of care and mortality? J Healthc Manag 2009; 54 15–29.
| 19227851PubMed |
[3] Conry MC, Humphries N, Morgan K, McGovan I, Montgomery A, Vedhara K, Panagopoulou E, McGee H. A ten year (2000–2010) stystematic review of interventions to improve quality of care in hospitals. BMC Health Serv Res 2012; 12 275
| A ten year (2000–2010) stystematic review of interventions to improve quality of care in hospitals.Crossref | GoogleScholarGoogle Scholar | 22925835PubMed |
[4] Goodall AH. Physician-leaders and hospital performance: is there an association? 2011. Available at: http://www.amandagoodall.com/SS&MarticletJuly2011.pdf [verified 22 June 2012].
[5] Veronesi G, Kirkpatrick I, Vallascas F. Clinicians on the board: what difference does it make? Soc Sci Med 2013; 77 147–55.
| Clinicians on the board: what difference does it make?Crossref | GoogleScholarGoogle Scholar | 23232025PubMed |
[6] Veronesi G, Kirkpatrick I, Altanlar A. Clinical leadership and the changing governance of public hospitals: implications for patient experience. Public Admin 2015;
| Clinical leadership and the changing governance of public hospitals: implications for patient experience.Crossref | GoogleScholarGoogle Scholar |
[7] Molinari C, Alexander J, Morlock L, Lyles CA. Does the hospital board need a doctor? The influence of physician board participation on hospital financial performance. Med Care 1995; 33 170–85.
| Does the hospital board need a doctor? The influence of physician board participation on hospital financial performance.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M7jvFKnsg%3D%3D&md5=993669b79fccebc494e44c579f4d2b10CAS | 7837825PubMed |
[8] Dickinson H, Ham C, Snelling I, Spurgeon P. Medical leadership arrangements in English healthcare organisations: findings from a national survey and case studies of NHS trusts. Health Serv Manage Res 2014; 26 119–25.
[9] Hammer A, Arah OA, DerSarkissian M, Thompson CA, Mannion R, Wagner C. The relationship between social capital and quality management systems in European hospitals: a quantitative study. PLoS ONE 2013; 8 e85662
| The relationship between social capital and quality management systems in European hospitals: a quantitative study.Crossref | GoogleScholarGoogle Scholar | 24392027PubMed |
[10] Baker GR, Denis J-L. Medical leadership in health care systems: from professional authority to organisational leadership. Public Money Manag 2011; 31 355–62.
| Medical leadership in health care systems: from professional authority to organisational leadership.Crossref | GoogleScholarGoogle Scholar |
[11] Dwyer AJ. Medical managers in contemporary healthcare organisations: a consideration of the literature. Aust Health Rev 2010; 34 514–22.
| Medical managers in contemporary healthcare organisations: a consideration of the literature.Crossref | GoogleScholarGoogle Scholar | 21108915PubMed |
[12] Landrigan C, Parry G, Bones C, Hackbarth A, Goldmann D, Sharek P. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med 2010; 363 2124–34.
| Temporal trends in rates of patient harm resulting from medical care.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXhsV2gs7vI&md5=57a1a49ccf1d6b1a3b6cd0463376d5c4CAS | 21105794PubMed |
[13] McCannon J, Berwick D. A new frontier in patient safety. JAMA 2011; 305 2221–2.
| A new frontier in patient safety.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXntVCntbo%3D&md5=d4cfddfcd6717466521c0dd56b458e95CAS | 21632485PubMed |
[14] Ehsani J, Duckett S, Jackson T. The incidence and cost of cardiac surgery adverse events in Australian (Victorian) hosptials 2003–2004. Eur J Health Econ 2007; 8 339–46.
| The incidence and cost of cardiac surgery adverse events in Australian (Victorian) hosptials 2003–2004.Crossref | GoogleScholarGoogle Scholar | 17347846PubMed |
[15] Bonias D, Leggat SG, Bartram T. Encouraging participation in health system reform: is clinical engagement a useful concept for policy and management? Aust Health Rev 2012; 36 378–83.
| Encouraging participation in health system reform: is clinical engagement a useful concept for policy and management?Crossref | GoogleScholarGoogle Scholar | 23062697PubMed |
[16] Mintzberg H. The structuring of organisations. Englewood Cliffs: Prentice-Hall; 1979.
[17] Braithwaite J. Between-group behaviour in health care: gaps, edges, boundaries, disconnections, weak ties, spaces and holes. A systematic review. BMC Health Serv Res 2010; 10 330
| Between-group behaviour in health care: gaps, edges, boundaries, disconnections, weak ties, spaces and holes. A systematic review.Crossref | GoogleScholarGoogle Scholar | 21134295PubMed |
[18] Ham C, Clark J, Spurgeon P, Dickinson H, Armit K. Doctors who become chief executives in the NHS: from keen amateurs to skilled professionals. J R Soc Med 2011; 104 113–19.
| Doctors who become chief executives in the NHS: from keen amateurs to skilled professionals.Crossref | GoogleScholarGoogle Scholar | 21357980PubMed |
[19] Wilson R, Van Der Weyden M. The safety of Australian healthcare: 10 years after QAHCS. Med J Aust 2005; 182 260–1.
| 15777136PubMed |
[20] Spurgeon P, Barwell F, Mazelan PM. Developing a medical engagement scale. Int J Clin Leadership. 2008; 16 213–23.
[21] Weiner BJ, Alexander JA, Shortell S. Leadership for quality improvement in health care: empirical evidence on hospital boards, managers, and physicians. Med Care Res Rev 1996; 53 397–416.
| Leadership for quality improvement in health care: empirical evidence on hospital boards, managers, and physicians.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s7htVyisw%3D%3D&md5=18d38b6f65074386edc2f5db98b3a786CAS | 10162958PubMed |
[22] Buchanan DA, Jordan S, Preston D, Smith A. Doctor in the process: the engagement of clinical directors in hospital management. J Manag Med 1997; 11 132–56.
| Doctor in the process: the engagement of clinical directors in hospital management.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svnsFSiuw%3D%3D&md5=ea601b714d0197dc2b6cd9710a28d156CAS |
[23] Cragg R, Marsden N, Wall D. Perceptions of the clinical director role. Br J Healthcare Manage 2008; 14 58–65.
| Perceptions of the clinical director role.Crossref | GoogleScholarGoogle Scholar |
[24] McKee L, Marnoch G, Dinnie N. Medical managers: puppetmasters or puppets? Sources of power and influence in clinical directorates. In Mark A, Dopson S, editors. Organisational behaviour in health care: the research agenda. Basingstoke: Macmillan Press Ltd; 1999. pp. 89–116.
[25] Braithwaite J, Westbrook M. A survey of staff attitudes and comparative managerial and non-managerial views in a clinical directorate. Health Serv Manage Res 2004; 17 141–66.
| A survey of staff attitudes and comparative managerial and non-managerial views in a clinical directorate.Crossref | GoogleScholarGoogle Scholar | 15285824PubMed |
[26] Braithwaite J, Westbrook M. Rethinking clinical organisational structures: an attitude survey of doctors, nurses and allied health staff in clinical directorates. J Health Serv Res Policy 2005; 10 10–17.
| Rethinking clinical organisational structures: an attitude survey of doctors, nurses and allied health staff in clinical directorates.Crossref | GoogleScholarGoogle Scholar | 15667699PubMed |
[27] Fitzgerald L. Moving clinicians into management: a professional challenge or threat? J Manag Med 1994; 8 32–44.
| Moving clinicians into management: a professional challenge or threat?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M3gtF2qsQ%3D%3D&md5=edb76f8b1d59ea940b687ebb131f4dc7CAS | 10161170PubMed |
[28] Fitzgerald L, Stuart J. Clinicians into management: on the change agenda or not? Health Serv Manage Res 1992; 5 137–46.
| 1:STN:280:DyaK3s%2FgtVWitg%3D%3D&md5=4babbb87a54182791955f4b32ec50952CAS | 10120980PubMed |
[29] Llewellyn S. Two way windows: clinicians as medical managers. Organ Stud 2001; 22 593–623.
| Two way windows: clinicians as medical managers.Crossref | GoogleScholarGoogle Scholar |
[30] Spurgeon P, Clark J, Ham C. Medical leadership: from the dark side to centre stage. London: Radcliffe Publishing Limited; 2011.
[31] Loh E. How and why doctors transition from clinical practice to senior hospital management: a case research study from Victoria, Australia. Int J Clin Leadership 2012; 17 235–44.
[32] Scott A, Joyce CM. The future of medical careers. Med J Aust 2014; 201 82–3.
| The future of medical careers.Crossref | GoogleScholarGoogle Scholar | 25045978PubMed |
[33] Geffen L. A brief history of medical education and training in Australia. Med J Aust 2014; 201 S19–22.
| A brief history of medical education and training in Australia.Crossref | GoogleScholarGoogle Scholar | 25047770PubMed |
[34] Busari J, Berkenbosch L, Brouns JW. Physicians as managers of health care delivery and the implications for postgraduate medical training: a literature review. Teach Learn Med 2011; 23 186–96.
| Physicians as managers of health care delivery and the implications for postgraduate medical training: a literature review.Crossref | GoogleScholarGoogle Scholar | 21516608PubMed |
[35] Bolsin S, Faunce T, Oakley J. Practical virtue ethics: healthcare whistleblowing and portable digital technology. J Med Ethics 2005; 31 612–18.
| Practical virtue ethics: healthcare whistleblowing and portable digital technology.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MrisV2jsA%3D%3D&md5=dcd0470be85b1856223e6584bbd8d304CAS | 16199607PubMed |
[36] Dickinson H, Ham C, Snelling I, Spurgeon P. Are we there yet? Models of medical leadership and their effectiveness: an exploratory study. Final report. Southampton: National Institute for Health Research Service Delivery and Organisation programme; 2013.