The Best Hospitals Are Run by Doctors, Not Managers

Anyone in the medical profession cannot help noticing that hospital leadership has been entrusted to generally-trained managers in recent years, rather than physicians.  In Britain, in particular, there have been rumblings from the medical staff for years, and the topic is approached in the 2008 Darzi Report (“ . . . greater clinician involvement in decision making . . .”) commissioned by the UK National Health Service.  This inspired Dr Amanda Goodall of the Institute for the Study of Labor, Germany, to examine the relationship between hospitals’ quality and the backgrounds of their leaders in 300 US hospitals.  Her findings are reported in the journal Social Science and Medicine.

The leaders of top-100 hospitals in three specialties – cancer, digestive disorders, and heart (including heart surgery) – were identified from a national database, and the personal histories of these 300 CEOs were used to classify them into physicians and non-physician managers.

There was a strong positive association between the ranked quality of a hospital and whether the CEO was a physician or not.  Hospital quality scores are approximately 25% higher in physician-run hospitals than in the average hospital. 

Dr Goodall says she was surprised by the strength of the association she uncovered.  But she stressed that more research would be needed before cause-and-effect could be properly understood.  While we’re waiting, we can watch what happens in the National Health Service in UK to see if the changes (if any) are beneficial.