Table 1 The phenomenon of doctor managers in 19 OECD countries
Country | MDs in Top Management Team | Formalized interaction between MDs and TM | Formalization into force since | MDs involvement in TM tasks | Type of tasks | MDs role in TM decisions |
|---|---|---|---|---|---|---|
Belgium | Medical doctors | YES | 1987 | YES | mostly advisory | Consultative |
Economists | ||||||
Managers | ||||||
Nurses | ||||||
Jurist | ||||||
Czech Republic | Medical doctors | YES | 2012 | YES | all - most managers are MD | Decisional |
Managers | ||||||
Denmark | Medical doctors | YES | 1990 | YES | support the development of clinical indicators & practice guidelines; education; human resources; | Decisional |
Economists | ||||||
Managers | ||||||
Nurses | ||||||
England | Economists | NO | N/A | YES | depending on internal processes and regulation; nothing standardized | |
Finance | ||||||
France | Medical doctors | YES | - | YES | e.g. infection management | Decisional (in practice) |
Managers | Consultative (in theory) | |||||
Germany | Medical doctors | YES | - | NO | N/A | Consultative |
Economists | ||||||
Managers | ||||||
Academia - where the case | ||||||
Israel | Medical doctors | YES | 2009 | YES | National Programme of Quality Indicators | Consultative |
Economists | ||||||
Italy | Medical doctors | NO | N/A | YES | only at a medical unit level | Consultative |
Managers | ||||||
Luxemburg | Medical doctors | YES | 1998 | YES | coordination of medical interdepartmental activities | Consultative |
Economists | ||||||
Nurses | ||||||
Poland | Medical doctors | YES | 1998 | YES | advisory and decisional | Decisional |
Managers | Consultative | |||||
Portugal | Medical doctors | YES | many years ago | YES | e.g. infection control | Decisional |
Economists | ||||||
Managers | ||||||
Nurses | Consultative | |||||
Legal | ||||||
Slovenia | Medical doctors | NO | N/A | YES | e.g. delivery of services, volume of services, waiting times; | Consultative |
Economists | ||||||
Spain | Medical doctors | YES - depends on the region | 2006 | YES | local guidelines | Decisional |
Managers | ||||||
Sweden | Medical doctors | NO - in most regions | N/A | YES | e.g. setting Quality Indicators and guidelines | Consultative |
Managers | ||||||
Turkey | Medical doctors | NO | N/A | YES | all hospital management task | Decisional |
Economists | ||||||
Japan | Medical doctors | YES | 2000 | YES | CEO | Decisional |
Singapore | Medical doctors | YES | 2009 | YES | almost all hospital management task | Decisional |
Managers | ||||||
South Korea | Medical doctors | YES - only in large hospitals | 2000 | YES | e.g. most decisions on hi-tech acquisitions and quality assessment | Decisional |
Managers - rarely | ||||||
Canada | Medical doctors | YES | 2003–2008 | YES | almost all hospital management task | Consultative |
Economists | ||||||
Managers | ||||||
Epidemiologists | ||||||