Friday, January 19, 2007


In my career as an NHS manager the times I enjoyed most and the times we achieved most was when I worked as manager in a close partnership with a senior doctor. As managers, whether we like it or not, we have to accept doctors have far more credibility with patients and politicians than managers ever will. I see that as a great opportunity for managers.

In my career I used to get on with the detail of day to day management and I left the leadership and 'spotlight role' as the realm of the doctor. Tactically as a manager I unashamedly ‘used’ the doctor to get over a point in any difficult argument with his peer doctors who may be resisting change. Doctors can sell a new concept to their peers far better than a manager and I was always comfortable keeping my head down leaving all that 'stuff' to the doctor.

It was also brilliant to have the support of the doctor in arguments with my own bosses which happened quite a lot. Managers in the NHS still have great respect for doctors and the more senior the doctor the more respect it seems. I used what I call the ‘credibility card’ often.

There have always been arguments about the role of doctors in management in the NHS and my view is clear. The doctors who make a positive decision to ‘do management’ make far better leaders than traditional NHS managers.

It is therefore very interesting to me that Heartlands Hospital in Birmingham, just down the road from us in Solihull, recently won an award as the best hospital in the UK. Click here for details.

Why is this interesting? - Because the Chief Executive and his Deputy are both Senior Doctors.

Of course all academic researchers will tell me this does not prove anything but it is interesting don’t you think?


Ray said...

Hmmm. Not just academic researchers that may object. Doctors are a powerful group within healthcare but, just as with any other professional clinical grouping, they have their own agenda. Within the mental health field, this is not always a good thing as problems tend to get medicalised, and social/political solutions givemn less emphasis.

I agree that managers need to work more closely with doctors, but the latter can be a law to themselves. I have attended leadership forums with managers and lead clinicians from numerous professions.... and hardly a doctor in sight. Chief executives at log aheads with medical directors...

But, yes, there is a need to work towards common goals.

Trevor Gay said...

Hi Ray – thanks for comments – hope you are well.

As you know I worked in mental health in my NHS career and I can relate to the worry you express about a ‘medical model’ emerging at the expense of the non medical aspects if we let Consultant Psychiatrists have all the power. I was very lucky to work with a Consultant for three years who was a champion of the ‘social model’ so that helped. He was very much in favour of developing community based services using multi-professional and indeed alternative and lay approaches to care of people with mental health problems. I accept however that he was unusual among his peers and you are right that most are probably not of his ilk.

The power struggle between Chief Exec and Medical Directors you are seeing probably has more to do with inflated personal egos (on both sides) than anything whatsoever to do with patient care.

Dr Grumble said...

I have attended leadership forums with managers and lead clinicians from numerous professions.... and hardly a doctor in sight.
Dr Grumble agrees that doctors are under represented at such forums. There may be various reasons for this. For one thing keeping up to speed with the technical aspects of medicine takes time. And, quite often, when Dr Grumble is invited to such things he is not given enough notice. If you have important clinical work to do you cannot just abandon your patients without getting somebody else to look after them.

There are a very few excellent doctor managers around and you would think that being a doctor would be something of an advantage. Sometimes though it's the doctors that can't doctor that head towards management - and some of those can't manage either.

Trevor Gay said...

Thanks Dr Grumble – the best arrangement I have ever come across is when a doctor and manager work together as a partnership. As a non-doctor I am unable to say whether these people are or are not good doctors but they have certainly bring lots of skills to the management/leadership table.