Management in Medicine

MANAGEMENT IN MEDICINE

Reynaldo O. Joson, M.D.

Introduction

Management and manage are derived from the Latin word, manus, meaning hand. Manage, therefore, literally means to handle and management, the handling of.

In the study and practice of medicine, and in life and in other professions for that matter, we cannot avoid encountering situations, problems, and people which and whom we have to handle or manage. Likewise, we cannot avoid being given assignments and responsibilities to handle or manage.

Furthermore, we cannot avoid initiating tasks and projects to satisfy our id, ego, and superego and which, again, we have to handle or manage.

In the study and practice of medicine, if we look at the competencies expected of a physician, which are to be able to:

1. solve the health problems of a community;

2. be an effective, efficient, and humane physician in managing patients;

3. be self-directed in continuing medical education;

4. be an effective and efficient administrator of a health care unit;

5. conduct health research;

6. conduct health education; and

7. pass the Philippine Board of Medicine examination;

all of them involve management.

Thus, a very basic competency that all physicians must have is management.

Whether it be management of self (time, ambition); people (patients, people in an organization or community); projects (education, research, health care unit, passing the board examination); and situations and problems, the basic management processes and principles are the same.

Please take a look at the table below which illustrates the universal application of management.

The only adjustment that you have to make is whether you are managing

- your own self;

- another individual person (say a patient);

- a group of people (say in a community or an organization); or

- a project that involves people.

In managing a group of people or a project that involves people, the seven processes or functions of management will be utilized, namely: planning, organizing, staffing, leading, controlling, evaluating, and improving.

Otherwise, you can just use planning, implementing, evaluation, and improving.

Below are some definitions of terms used in management as gotten from the book of Harold Koontz and Heinz Weihrich, entitled "Management", 9th edition (1989): (Note: this book is more on the management of people.)

MANAGEMENT - The process of designing and maintaining an environment in which individuals working together in groups accomplish efficiently selected aims.

PLANNING - Selecting missions and objectives and the strategies, policies, programs, and procedures for achieving them; decision making; the selection of a course of action from among alternatives.

OBJECTIVES or GOALS - The ends toward which activity is aimed - the end points of planning.

EFFECTIVENESS - The achievement of objectives; the achievement of desired effects.

EFFICIENCY - The achievement of the ends with the least amount of resources; the accomplishment of objectives at the least cost or other unsought consequences.

STRATEGIES - General programs of action and deployment of resources to attain comprehensive objectives.

ORGANIZING - Establishing an intentional structure of roles for people to fill in an organization.

STAFFING - Filling, and keeping filled, the positions in the organization structure with competent people. This is done through (1) defining work-force requirement; (2) inventorying the people available; (3) recruiting; (4) selecting candidates for positions; (5) placing candidates; (6) promoting; (7) appraising; (8) planning the career of; (9) compensating; and (10) training or otherwise developing people.

LEADING - The function of managers involving the process of influencing people so that they will contribute to organization and group goals.

CONTROLLING - The managerial function of measuring and correcting performance of activities of subordinates in order to assure that enterprise objectives and plans are being accomplished.

Below is a management framework that I suggest we use:

ROJ@17apr4