Salome K. Ireri PhD student Manchester Business School

Transcription

1 A qualitative and quantitative study of medical leadership and management: Experiences, competencies and development needs of doctor managers in the United Kingdom Salome K. Ireri PhD student Manchester Business School

2 Format of the presentation Introduction Purpose of the study Methodology Results Experiences Competencies Training & development needs Views of the MLCF (2008) Conclusion

3 Introduction Healthcare systems need strong leadership if they are to be sustainable and responsive to the health needs (Dickson et al. 2007) Involving doctors in management has potential to improve healthcare delivery (Darzi report 2008, NHS Confed 2009) Very little formal evaluation of the capacity of doctor managers as well as their needs for future training (Ham & Dickinson 2008) Surge in development of competency frameworks in healthcare but limited literature on their applicability

4 Purpose of the study To explore the experiences, competencies and development needs of doctor managers in the United Kingdom To test the applicability of a leadership competency framework designed for doctors (MLCF 2008)

5 Methodology Qualitative interviews N=13 Authenticate findings with supplementary information Transcribe, code & analyse data Compare data Interview & survey data Survey questionnaire N=189 Enter data into SPSS Analyse Statistical analysis Report Competencies, Correlations

6 Experiences Positive and negative

7 How doctors in UK feel about management Enjoyable So far it has been very easy to be honest, it has been enjoyable Coming here has been fantastic. I have thoroughly enjoyed it Stressful and difficult It s just a very hard job because you ve got the mixed roles, clinician, manager, policeman... This is the hardest I have taken on in my whole career partly because of inexperience Management is not my world. The clinical world is my world, so I am in a strange environment. Well, it has been quite stressful It can be very frustrating More negative than positive comments

8 Motivation/satisfiers Influencing decision making Better service delivery Disincentives/dissatisfiers Lack of exposure -inadequacy Inadequate support Heavy work load, tiring, demanding Difficult to deliver expected results: frequent change in targets, reorganisations Too much accountability Lack of clarity Personal costs: Isolation Thankless job Currently healthcare organisations are more professionally run: clinical governance, clinical involvement at board level attracting younger doctors to management

9 Competencies Wide cross-section of skills which include communication, decision making, marketing, negotiation... Professional Credibility reported as most important You ve got first and foremost be a good clinician because if they respect your clinical work, they are more likely to respect you as a manager. It s very important to have someone who is very strong clinically to survive as a director because my colleagues can easily tramp on you Most skills inherent in medical school training: management tasks related to patient pathways (transferable) Skewed data: survey participants reported themselves highly competent (strongly agree to agree categories) Analysis of interviews against the MLCF (2008): participants ranked below post graduate level

10 Training and development Consensus: SPR level Needs Financial management The general clinician has little concept about what working in a budget is, I think that is something the NHS needs to change HRM I struggle with trying to get people to meaningfully discuss their job plans The difficult people are the medics. There is no question about it. They are not always very good listeners, paradoxically given the profession they are in Styles of learning: no consensus Experience on the job: shadowing, mentoring, learning sets etc Formal courses: BAMM, MSc-hcmx, MPH, MBA etc

11 Hypotheses testing Doctors who have managed for longer periods are more competent Doctors who are older are more competent Doctors who have formal management training are more competent Doctors management capabilities vary in different specialties Very weak correlation Very weak correlation Extent of management training was a predictor of competence Overall, medical specialties were not predictors for competence

12 Doctors opinions on contents of the MLCF (2008) 58% positive comments: excellent representation, comprehensive, a wide cross-section 41.5% negative comments: subjective (source of bias), not representative, jargon from DOH, repetitive, theoretical. What can I say other than I m good at what I do? I will respond positively if I have any self esteem Are we able to give you an objective answer? I would like to know what my team thinks 1t is difficult to identify personal qualities from the organisation s 0.5% neutral (generic); apply to leaders and managers in general

13 Conclusion The study has provided a better understanding of, The experiences, competencies, training and development needs of doctors in management. The limitations of leadership competency frameworks in healthcare and limitations of self evaluation. The validity of some hypotheses

14