Medicine and management in European hospitals : a comparative overview

Kirkpatrick, I; Kuhlmann, E; Hartley, KA; Dent, M; Lega, F

Abstract

Background: Since the early 1980s all European countries have given priority to reforming the management of
health services. A distinctive feature of these reforms has also been the drive to co-opt professionals themselves
into the management of services, taking on full time or part time (hybrid) management or leadership roles.
However, although these trends are well documented in the literature, our understanding of the nature and impact
of reforms and how they are re-shaping the relationship between medicine and management remains limited.
Most studies have tended to be nationally specific, located within a single discipline and focused primarily on
describing new management practices. This article serves as an Introduction to a special issue of BMC Health
Services Research which seeks to address these concerns. It builds on the work of a European Union funded COST
Action (ISO903) which ran between 2009 and 2013, focusing specifically on the changing relationship between
medicine and management in a European context.
Main text: Prior to describing the contributions to the special issue, this Introduction sets the scene by exploring
four main questions which have characterised much of the recent literature on medicine and management. First is
the question of what we understand by the changing relationship between medicine and management and in
particular which this means for the emergence of so called ‘hybrid’ clinical leader roles? A second question
concerns the forces that have driven change, in particular those relating to the wider project of management
reforms. Third, we raise questions of how medical professionals have responded to these changes and what factors
have shaped their responses. Lastly we consider what some of the outcomes of greater medical involvement in
management and leadership might be, both in terms of intended and unintended outcomes.
Conclusions: The paper concludes by summarising the contributions to the special issue and highlighting the
need to extend research in this area by focusing more on comparative dimensions of change. It is argued that
future research would also benefit theoretically by drawing together insights from health policy and management
literatures.
Keywords: Medicine, Management, Leadership, Public hospitals, Comparative research, Hybrid roles, Performance

Citation

Kirkpatrick, I., Kuhlmann, E., Hartley, K., Dent, M., & Lega, F. (2016). Medicine and management in European hospitals : a comparative overview. BMC Health Services Research, 16(S2:171), 7-14. https://doi.org/10.1186/s12913-016-1388-4

• Journal Article Type: Article
• Acceptance Date: Mar 29, 2016
• Online Publication Date: May 24, 2016
• Publication Date: May 24, 2016
• Deposit Date: Jun 1, 2016
• Publicly Available Date: Jun 1, 2016
• Journal: BMC Health Services Research
• Electronic ISSN: 1472-6963
• Publisher: Springer Verlag
• Volume: 16
• Issue: S2:171
• Pages: 7-14
• DOI: https://doi.org/10.1186/s12913-016-1388-4
• Publisher URL: http://dx.doi.org/10.1186/s12913-016-1388-4
• Additional Information: Projects : Enhancing the role of medicine in the management of European health systems - implications for control, innovation and user voice