Managing healthcare facilities should not be left to physicians

Currently, the government- owned hospitals and health units are described as inefficient and ineffective. This is evidenced by patient dissatisfaction, disaffection and medical ‘tourism’ to private hospitals.

Lack of management capacity is a key stumbling block to attaining the goals of the health sector. Health facilities are important vehicles for delivery of healthcare, and hospital managers to a large extent are responsible for operationalising the visions and objectives.
Uganda’s health facilities need efficient and effective managers to run the scarce health resources in order to improve healthcare. Health managers need a combination of good leadership, entrepreneurial and administrative skills to meet the demands that the changing socio-political, economic and technological environment presents plus expectations of patients, colleagues, politicians and the public.

Currently, the government- owned hospitals and health units are described as inefficient and ineffective. This is evidenced by patient dissatisfaction, disaffection and medical ‘tourism’ to private hospitals. On the other hand, privately-owned and managed hospitals are among the most efficient, effective and profitable businesses.

Public hospitals should be managed from a business perspective to increase customer satisfaction. This requires skilled management. Often times, our hospitals are managed by fresh graduates from medical schools without formal training in management.

Why can’t hospitals and health units in Uganda be managed by non-physicians with better management knowledge and skills?
Non-doctor managers would free doctors from administrative work to attend to patients. This would further lessen the doctor-patient ratio and improve management of scarce health resources for better service delivery.
In the UK and United States, most hospital chief executive officers are not physicians.

Of the 6500 hospitals in the US, only 235 are managed by physicians (Horton at al, 2008). Effective management of healthcare requires the knowledge, skills, ethics and values of management.

Doctors’ training mainly focuses on medicine and patient care as opposed to management and administration.

Health managers need competencies in financial and organisational management, people management skills to enable them retain and motivate workers, and achieve objectives through and with others, and strategic skills to help them set key objectives based on understanding of what is happening inside and outside health facilities.

The efficiency of management is assessed on how best scarce resources are used to produce better results. The reason health services are poor is partly because the scarce resources are not utilised efficiently.

Non-physician CEOs can manage health facilities better. Management of healthcare in Uganda needs re-orientation to improve health service delivery.

The bottom line is that every health manager, whether a doctor or not, should have adequate training in management.

Innocent Atuhe,
innocent.atuhe@stud.umu.ac.ug