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Do Expert Clinicians Make the Best Managers? Evidence from Hospitals in Denmark, Australia and Switzerland

Baker, A. and Goodall, A. H. ORCID: 0000-0002-9074-1157 (2021). Do Expert Clinicians Make the Best Managers? Evidence from Hospitals in Denmark, Australia and Switzerland. BMJ Leader, doi: 10.1136/leader-2021-000483

Abstract

Introduction
Hospital quality rests upon the morale and productivity of those who work in them. It is therefore important to try to understand the kinds of team leaders that create high morale within hospitals.

Methods
This study collects and examines data on 3000 physicians in hospitals from Denmark, Australia, and Switzerland. It estimates regression equations to study the statistical predictors of levels of doctors’ job satisfaction, their intentions to quit or stay in their current hospital, and their assessment of the leadership quality of their immediate manager. A particular concern of this study is to probe the potential role played by clinical expertise among those in charge of other physicians.

Results
When led by managers with high clinical expertise, hospital physicians are (i) more satisfied with their jobs, (ii) more satisfied with their supervisors’ effectiveness, and (iii) less likely to wish to quit their current job. These findings are robust to adjustment for potential confounders, including age and job seniority, and pass a variety of statistical checks (including clustering of standard errors and checking for omitted variable bias). They are replicated in each of the three nations.

Conclusion
Physicians are happier with their jobs when led by outstanding clinical experts. It is not sufficient, it appears from this evidence, for leaders merely to be clinicians. This suggests that -- though only an idealized and presumably infeasible randomized experiment could allow complete certainty -- there is a natural case for managers within a hospital hierarchy to be drawn from the ranks of those who are themselves outstanding clinicians.

Publication Type: Article
Additional Information: This article has been accepted for publication in BMJ Leader, 2021, following peer review, and the Version of Record will be available online at https://bmjleader.bmj.com/. © Authors (or their employer(s)) 2021. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) http://creativecommons.org.
Publisher Keywords: Hospital governance; managers; expert leaders; job satisfaction; physicians; medicine
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: Bayes Business School > Management
Date available in CRO: 02 Aug 2021 07:56
Date deposited: 2 August 2021
Date of acceptance: 30 July 2021
Date of first online publication: 12 August 2021
URI: https://openaccess.city.ac.uk/id/eprint/26531
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