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Productivity Profiles - Medical Specialist Vs Physician (Vs Hospital)


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. . . A manager should understand the productivity profiles of its team members otherwise he will not be able to manage them. . .

Sketching the productivity profile of the last mentioned (the hospital), one could say that the hospital offers the facilities and the support (equipment and infrastructure) so that individual specialists, the more generalistic physicians and nurses (m/f) can perform their activities . . . all in order to serve clients or patients. The hospital management forms the part to organize the whole by defining policies outlining strategies, etc.

How future hospitals will develop is rather uncertain. Yet with a constant technological innovation, the work of the medical specialist and the more general physician is already changing and will change more over time.

Unique for any specialist and therefore also for medical specialists is that they “cover" a certain functional area of expertise. Clients however are not served by a small area of expertise but by a larger or more general functional area. To serve a client from any company one needs specialists on one hand and generalists on the other who oversee the whole trajectory and keep track that the client is properly communicated about all the required (specialistic) activities.

The hospital environment is symbolic for the complexity of specialists. Some call it “turf wars:" health care warriors struggle to defend and expand their increasingly overlapping empires. (1).

As physician specialties continue to evolve, it is inevitable that conflicts will arise among different specialists approaching similar health issues from varying backgrounds (1).

The article has a legal viewpoint because of the situation (in the US and other countries) where different legal healthcare entities exists (specialists are organized in separate entities beyond the legal hospital organization. The radiology entity (for example) is not only a department within a hospital but may exercise private activities for other entities. Without this legal focus, the “turf" wars happen anyhow in hospitals.

The technical evolution of radiology equipment makes it possible to shift away from its original diagnostic field towards / entering the field of surgery (invasive technology) and that is how one field of expertise (radiology) enters the other (surgery). This is one way to show how specialties compete and rival amongst each other.

"At the same time, a number of other specialties developed procedures which relied on the use of technology that was generally only available in the radiology department: the imaging modalities. Other specialist all wanted access to this advanced technology as well. " (2)

This is where hospital management comes in. Whether one specialist perceives this situation as a threat or an opportunity depends on the vision and policy of the hospital as a group (of individual companies).
Hospital management should most of all understand the change of productivity (the radiologist expanding from diagnosis towards curing) and how this will affect the overall organization.

The linking pin in understanding this turf-war is productivity. Productivity has both a business side (diagnosis, versus treatment in curing patients) as well as an organizational side (who - in sense of different types of resources - is doing what?)

For example the physician will play more of an account management role, mediating between the client and the various specialists. But whatever role-distribution is chosen, it must be clear for all, and most of all for the patient.

As entrepreneurship is a more and more valued these days one (hospital management) should operate as a referee between the various specialists.

And this can only be done when understanding what the impact is on both the business as on the organization when changing the roles of the specialists and physician in the hospital.

(1) -

H. J. B.

© 2008 Hans Bool


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