₦airaland Forum

hazyfm: [size=18pt]Supportive Management?? What are you saying?? Where you trained by a Doctor or a Herbalist??[/size]
Don't tell me you were thought this bull-shiit in school.
Supportive Management has nothing to do with a very treating a strange virus infected patient.
Visit the link below stop posting bullshits
http://medical-dictionary.thefreedictionary.com/supportive+treatment

i didn't Hv to visit ur link.,,, there is no point exchanging posts wt u since u obviously know nothing bout core medicine

lakamua: I hv always known dat reading big books does not mean a person is intelligent. see hw they want to commit suicide even when nature has tried to protect them by bringing the disease when they were on strike. for ur information foolish doctors. u dont have a cure so ur presence is just a means to spread it and it is likely airborne. use ur brains. wisdom is not gotten by cramming big books

if u were using ur brains u would know that the sine qua non to saving lives( which is d doctor"s responsibility)is not necessarily via providing a cure!!!!

hazyfm:

YES AS SHALLOW AS NIGERIAN DOCTORS
How's your strike going?

there is an IMPORTANT arm of medicine called supportive management . This is employed by doctors when definitive cure for an ailment still eludes mankind. And such managements saves lives evryday ..,,,, so now read u and ur friend"s post again and sincerely measure ur own shallowness!
U think d only way drs save lives if via having a CURE My friend u are a joke

duni04: Well i would know because i have access to the hospital. No single doctor has volunteered. I have no business with their industrial action, i'm just trying to update people on the situation with ebola in Nigeria. If u believe what you're reading in the media, goodluck to you

what is the colour of the gate of mainland hospital yaba What facility is intervening between it and military hospital yaba? Answer these question within 24hrs of this my post then I will know u aren't a lier

duni04: Nobody can be forced to attend to any suspected case of ebola irrespective of whatever meeting anybody held. The doctors are naturally scared since health care workers have a higher risk of contracting the virus and the isolation facilities at the hospital are not trustworthy. As of today, no doctor has volunteered to treat any of the patients. Only nurses are attending now

hmmm so how are theses ur nurses "attending" is it that they are "admitting"? ,,, u people just like lies

duni04: Well i would know because i have access to the hospital. No single doctor has volunteered. I have no business with their industrial action, i'm just trying to update people on the situation with ebola in Nigeria. If u believe what you're reading in the media, goodluck to you

u are a blatant lier . I am currently at military hospital yaba (68NARHY).... It's d closest facility to mainland hospital yaba. Consultants(doctors) from lasuth and Luth are in there as we speak . U said u have acces to mainland hospital yaba?? So tell me what is the colour of the main gate of mainland hospital yaba... Lol .,, google can't help u with that!!

dozzybaba: Must you NMA guys always play politics with everything?. A JOHESU member, a matron is also currently down with the disease. She is critical condition. haba!

i agree with u . Definitely nurses are quite important. Remove them from the johesu , let the other johesu go on strike for a hundred yrs and their absence in the hospital won't be felt

hazyfm: YOU AND YOUR STRIKING COLLEAGUES. WHAT ARE THEY TREATING? YOU CAN'T TREAT A DISEASE WITHOUT CURE
1. FIRST RESUME WORK
2. FIND A CURE
3. TREAT YOUR INFECTED PATIENTS

very shallow

prettyprettywow: http://www.punchng.com/news/fg-moves-to-privatise-hospitals/

have seen that article before... Where were they "cryin" What's ur take on privatization??

The interviewer asked him about PRIVATIZATION ... But he comfortably dodged the question..hahahaha... He is a joker

sogodihno: It seems dt NMA has not realize, dt dey av lose dz battle already. court has ruled in favour of JOHESU and dia is nothing anybody can do to that. The court wil not go back on dia decision. NMA! shud call of strike now to save face

NO NMA isn't gonna call off the strike . They are out of the hospital. Prove that u are equal to the task. Let ur funny president of medical lab science who thinks he can bring the age long student politics into the hospital call it's member out tomorrow and start CONSULTING

Sylverly: don't you think that is more reason why their request should be granted...in order to meet up the present challenges.

what present challenge? There is one already. Ebola is there doctors aren't around let them rally round their consultant pharmacists and PHARM D... Let them man the infectious disease department

LOL don't mind nigerian pharmacists,rather than for them to face pharmaceutical research, production and proper dispensing of drugs which are undoubtedly their abode. They are busy fighting for clinical posts and titles with the medical doctors in hospitals; the doctor"s abode!!!

prettyprettywow: so why are consultant Drs crying when they heard that govt is planning to privatize govt hospitals? guess they know better than you. Atleast, NMA will stop agitating for nonsense and face their work. Let govt privatize health care after granting consultancy staus to others

could u please provide source for ur above statement viz a viz doctors crying when they heard about planned privatization

ziga: I think we might be saying the same thing.

Management comes mostly with experience. Added qualifications however will be a bonus.

So, just like the universities are not run by outside CEOs, hospitals shouldn't be run by outside CEOs.

yea ... Exactly!

jpphilips: As much as I appreciate your counter argument, I still beg to differ as regards your reference to soldiers, every profession enjoys a level of privilege depending on your level of professionalism.

let us stick to the Doctor -soldier analogy, the Soldiers enjoy their perks as well not just doctors, if in doubt, ans the following questions;

Who drives from cotonou to Nigeria without paying a single Govt revenue?
who drives a vehicle for 22yrs and for that period never renewed his papers?
who is that privileged citizen whose kids go to command schools free?
who is that citizen who can access health care anywhere in the country in any military hospital free?
who is that citizen who drives without a license and nobody dare ask him questions?
Who drives on BRT lane?
who scratches your car on the road, confiscates yours while you fix his?
who by an unfortunate accident of their demise in the hands of a civilian and the nation comes to a stop?
who buys land but pays nothing to both state, LGA, Omonile, Obioakkpor and other revenues, by the sign post "MIlitary zone" every evil is kept at bay?
who uses electricity for over 30yrs and never pays his bill and nobody coughs?
who has the power to arrest any civilian and beat the living day light out of you yet nobody coughs?
who enters any public transport and never pays a dime by virtue of his uniform?
who has the right to commit any crime of his choice by virtue of his uniform?
Who is that privileged citizen who is not tried in conventional courts, he is tried by friends and colleagues in the name of court marshal?

If you agree soldiers enjoy some certain privileges, why wont the doctors enjoy theirs?
Doctors have said, leave consultancy for us, anybody who wish to have that tag should kindly enroll in the medical school, is it too much to ask?

very interesting and funny tho laden with absolute facts... Brilliant write up!

sogodihno: And u guys are part of those people dt limited hospital pharmacy to just dispensing. if pharmacist want to counsel d patient concernin d drug therapy, use etc. U are d one dt wil complain dt they A taking ur patients away frm u. no wonder doctor of pharmacy has not see d light of d day.
Nigerian ah! SMH

while dispensing why don't u tell them all u think they need to know about the medication at the counter?

drered: Furnish with links "my friend".

dont be lazy

ziga: The main job in the university is to teach. True.

And isn't the duty of the Vice chancellor administrative

Or who does the VC teach

is the vice chancellor from pharmacy, medicine, engineering an administrator in qualification sense ? So to use ur skewed Physician CMD logic , those professors shouldn't be appointed VCs after all d VC post is administrative just like the CMD"s

drered: 235 out of 6500 hospitals, a meagre 0.04% is led by physicians and you don't think its for a reason? Even the physicians that lead this hospitals have added qualifications and leadership skills or you think this qualities are by default inherent in doctors? In saner climes they apply what works.. And what works isn't making dr's CEO just cuz they are doctors cuz if that was it, it will be expressed in the number of hospitals led by MD's..

so why is NHS reverting to dr only CEO ? Use ur Internet my friend

Lagusta: Hmmmm

a doctor must be appointed as CMD of a teaching hospital IF AND ONLY IF he has met the basic requirements i.e MBA, MPA, and maybe an MPH...

In fact, i believe onlyPUBLIC HEALTH PHYSICIANS should be CMD, or doctors with MBBS, then the MPH, MBA and of course, a Ph.D to crown it all...

Whats the business of a gynecologist, pediatrician or even a surgeon being the CMD, they usually return stagnated and not up-to-date on recent medical breakthroughs...

Well, thats my opinion tho

funny enuf @ lagusta u REALY did make a lot of sense with ur post above. It might interest u to know that most of these teaching hospitals CMDs are university professors.... Far beyond just having a PHD

Lagusta: Hmmmm

a doctor must be appointed as CMD of a teaching hospital IF AND ONLY IF he has met the basic requirements i.e MBA, MPA, and maybe an MPH...

In fact, i believe onlyPUBLIC HEALTH PHYSICIANS should be CMD, or doctors with MBBS, then the MPH, MBA and of course, a Ph.D to crown it all...

Whats the business of a gynecologist, pediatrician or even a surgeon being the CMD, they usually return stagnated and not up-to-date on recent medical breakthroughs...

Well, thats my opinion tho

what's ur opinion on professor of pharmacy becoming a federal university vice chancellor

@mrs/mr/nurse /physio/pharm pettyprettyprettywow take ur colleagues and relocate to the federal universities in collaboration with ur NASU members go and order the university governing councils to cease having vice chancellors who arent from the department of management and accounting!!

Yet again mr otizzz u are yet to explain why most vice chancellors of universities are not from the department of management!

ottizz: Read my first post on this topic and see my answer to your question.

y should he waste his time to read ur first post?? Wasn't it in ur first post u wrote that a CNO should be equal to a CMD!!! That REALY shows the depth of ur knowledge . U didn't even talk about comparing ur CNO to a CMO who in an hospital is still rightfully placed higher on the organogram than ur CNO. Instead u jumped to equate a CNO to a CMD. Y don't u start comparing a warrant officer in the army to a brig general... U funny!

ottizz: What?
Okay, let me break it down for you, as you are still unable to grasp my point. In a health-system there are many things involved. Yes, the ultimate end is patient care, however, there are a lot of things that have to happen correctly in other to get to this ultimate end. It will take someone that is able to deal harmoniously with all the departments so they can all work synchronously to reach this common goal. The departments in a health-system include, but not limited to nursing, medicine, engineering, pharmacy, janitorial, central supply, security, accounting, information technology, and human resources. This person has to oversee a lot of budgetary issues, patient satisfaction issues, and community awareness and citizenship issues, etc. That is why there is a field called health care administration. If a physician has the vast experience to deal with all these and become the CEO of such a health-system, it will have less to do with his/her medical license but more with his/her managerial expertise. But to have a physician manage the hospital based just on their medical degree is outright ridiculous and will produce no growth for that particular hospital.

is that what u meant by "breaking it down"?? Very funny. Hv u ever asked urself why the majority of the most prestigious hospitals in the UK and US remain headed by medical doctors?? Look my friend, beyond what u learn in school as far as management is concerned u will pick up what u need to succeed as long as u smart; an average doctor is expected to be smart (true or false?) A specialist Dr has the advantage that he/ she has acquired a deep intuitive knowledge about the core business of their organisations and this helps with decision-making and institutional strategy. Falcone and Satiani (2008) suggest that a physician-leader who has spent years as a medical practitioner has acquired integrity that implies “walking the walk” (2008, p92) This ability enhances a leader’s credibility. Physician-leaders who have greater credibility tend to act as role models for medical staff and their presence also help hospitals to attract talented medical personnel.1. Y is it that hospitals positioned higher in the US News and World Report’s “Best Hospitals” ranking are led disproportionately by physicians. 2. Y are they currently reverting to Dr only CEO under NHS?( since 2008) 3. Y do Nigerians jump to copy others not minding their own peculiarity or even not minding to study the current success or demerit of such policies where they exist . As long as it is existing somewhere around d globe then they just want to copy

prettyprettywow: The findings do not prove that doctors make more effective leaders than professional managers.


correlation does not mean causation. So many limitations. Atleast he admitted the numerous limitations in the study. and I wonder why the study has not been replicated.

This type of study is better carried out using a longitudinal research approach rather than cross-sectional.

longitudinal or cross sectional or whatever . THE POINT IS THAT THE VERY PRESTIGEOUS HOSPITALS IN THE UK AND US ARE STILL VERY MUCH HEADED BY MEDICAL DOCTORS AS CMD/CEO.

Physician-leaders and hospital performance: Is there an association?

Amanda Goodall, 21 July 2011

In the past, hospitals were routinely led by doctors. That has changed. In the UK and the US, most hospital chief executive officers (CEOs) are non-physician managers rather than physicians (Falcone and Satiani 2008). Of the 6,500 hospitals in the US, only 235 are led by physicians (Gunderman and Kanter 2009).

It has been suggested that placing physicians in leadership positions can result in improved hospital performance and patient care (Horton 2008, Falcone and Satiani 2008, Darzi 2009, Candace and Giordana 2009, Stoller 2009, Dwyer 2010). The UK has recently established five academic health science centres. Their mission is to bring the practice of medicine closer to research – in the hope that innovative science can more quickly be translated into clinical procedures (Smith 2009). Physician leadership was also prioritised in the 2008 National Health Service (NHS) review (Darzi 2008, 2009). Some outstanding US medical facilities – for example the Cleveland and Mayo clinics – have explicitly introduced leadership training (e.g. Stoller et al. 2007), and management and leadership education is being incorporated into medical degrees.

Despite the growing body of research into hospital performance (see Bloom et al. 2010 and Gaynor and Propper 2010 on this site), there are currently no empirical studies that assess the physician-leadership hypothesis that hospitals perform better when they are led by doctors. To establish a clear relationship between leadership and organizational outcomes is challenging. Unlike in medical trials, random assignment – in this case of chief executive officers to hospitals – cannot be used. My research provides an empirical inquiry (Goodall 2011). It looks at the leaders currently being hired by hospitals and examines whether CEOs in hospitals ranked higher typically physicians or non-medical managers.

The wealthiest and most prestigious hospitals arguably have the widest choice of leadership candidates. If it can be shown that hospitals positioned higher in a widely-used media ranking are more likely to be led by medical experts rather than managers, this is one form of evidence that physician-leaders may make effective CEOs.

Studying CEOs of top-ranked US hospitals

The paper identifies the CEOs in the top ranked hospitals in America – determining whether those hospitals situated higher in the league-table are more likely to be headed by physician-leaders or professional managers.To do this, one particular quality ranking is used, namely, the league tables produced by US News and World Report’s “Best Hospitals” 2009. I construct a dataset on CEOs in the top-100 hospitals in the three specialties of cancer, digestive disorders, and heart and heart surgery.

The US News and World Report ranking is designed to inform consumers about where to seek treatments for serious or complex medical problems. Media-generated league tables cannot be viewed as entirely reliable measures of quality; nonetheless, using rating systems as heuristic devices to assess healthcare providers has become common in the US (Schneider and Epstein 1998) and it has been shown to influence consumers’ behaviour (Pope 2009). I use this ranking because it is one of the most established. The data in my study cover the top-100 hospitals in the three specialist fields of cancer, digestive disorders, and heart and heart surgery. Each hospital CEO is then identified and classified into one of two categories – physician-leaders, who have been trained in medicine (MD), and leaders who are non-physician managers.

Physician-led hospitals are higher-quality hospitals

To establish whether hospitals higher in the rankings are more likely to be led by physicians, I use t-tests and regression equations. I do this for the top-100 hospitals in each of the three medical fields of cancer, heart and heart surgery and digestive disorders.

In the field of cancer there are 51 physician-leaders among this set of 100 CEOs. Thirty-three are in the top-50 hospitals, and 18 lead hospitals in the lower 50 group. For the other two specialities, there are, respectively, 34 physician-leaders in the top-100 hospitals in digestive disorders, and 37 in heart and heart surgery. As can be seen in Figure 1, in each of the three cases, the average hospital quality score of hospitals where the chief executive officer is a physician is greater than the score of the hospitals where the CEO is a professional manager.

Figure 1. Average hospital quality score of hospitals led by physician CEOs and manager CEOs in three specialty fields



In the statistical analyses, the regression equations reveal that the presence of a physician-CEO is positively associated with an extra 8 to 9 hospital quality points (at the p<0.001 level) – in short, hospital quality scores are approximately 25% higher in physician-run hospitals than in the average hospital.

To control for the size of hospital, in the field of cancer I included a variable for the number of beds. However, this size variable was insignificant and, importantly, it did not affect the importance of physician-leaders.

Why are better hospitals more likely to be physician-led?

This study’s results are cross-sectional associations and use one particular hospital-quality ranking. This means they have important limitations. The findings do not prove that doctors make more effective leaders than professional managers. Potentially, they may even reveal a form of the reverse – assortative matching – in that the top hospitals may be more likely to seek out MDs as leaders and vice versa. Arguably, however, the better hospitals will have a wider pool of CEO candidates from which to choose, because of the extra status and wealth that they attract. This makes the fact established in this study an interesting one. The results show that hospitals positioned highest in the ranking have made judgements that differ from those hospitals lower down. On average they have chosen to hire physician-leaders as CEOs.

These findings are consistent with my earlier work on the role of “expert leaders” in other (non-medical) settings – for example, presidents of research universities (Goodall 2006 2009a,b) and NBA basketball coaches (Goodall et al. 2011). Cross-sectional analyses can only be suggestive of causality. Nevertheless, it is interesting to consider possible explanations. Experts may have the advantage that they have acquired a deep intuitive knowledge about the core business of their organisations and this may help with decision-making and institutional strategy. Falcone and Satiani (2008) suggest that a physician-leader who has spent years as a medical practitioner has acquired integrity that implies “walking the walk” (2008, p92) which, they argue, enhances a leader’s credibility. Physician-leaders who have greater credibility may act as role models for medical staff and their presence may help hospitals to attract talented medical personnel. However, such explanations are merely suggestive; the mechanisms are not properly understood.

There has been much discussion in the US, and increasingly in the UK, about the relative merits of having physicians and non-physician managers in leadership positions. Yet no evidence has been published one way or the other. This work does not establish that physicians make more effective leaders when compared with professional managers; but it starts the empirical process. It finds – in each of three disciplinary fields – that hospitals positioned higher in the US News and World Report’s “Best Hospitals” ranking are led disproportionately by physicians. The next, and vital, step for researchers is to design longitudinal inquiries into the possibility that physician-leaders improve the performance of American hospitals

References

US News and World Report (2009) “America’s Best Hospitals” ,methodology and ranking, produced by Research Triangle Institute.

Bloom, Nicholas, Rebecca Homkes, Rafaella Sadun, and John Van Reenen (2010), “Why good practices really matter in healthcare”, VoxEU.org, 17 December.

Candace, I and RW Giordano (2009), “Doctors as leaders”, British Medical Journal, 338:b1555.

Darzi, A (2008), High quality care for all: NHS next stage review final report,Department of Health, London.

Darzi, A (2009), “A Time for revolutions — The role of physicians in health care reform”, New England Journal of Medicine, 361:e8.

Dwyer, AJ (2010), “Medical managers in contemporary healthcare organisations: a consideration of the literature”, Australian Health Review, 34:514-522.

Falcone, BE and B Satiani (2008), “Physician as hospital chief executive officer”, Vascular and Endovascular Surgery, 42:88-94.

Gaynor, Marty and Carol Propper (2010), “Healthcare competition saves lives”, VoxEU.org, 23 August.

Goodall, AH (2006), “Should research universities be led by top researchers, and are they?”, Journal of Documentation, 62:388-411.

Goodall, AH (2009a), “Highly cited leaders and the performance of research universities”, Research Policy, 38:1079-1092.

Goodall, AH (2009b), Socrates in the boardroom: Why research universities should be led by top scholars, Princeton University Press.

Goodall, AH (2011) “Physician-leaders and hospital performance: Is there an association?”, Social Science and Medicine, forthcoming

Goodall, AH, MK Lawrence, and AJ Oswald (2011), “Why do leaders matter? A study of expert knowledge in a superstar setting”, Journal of Economic Behaviour and Organization, 77:265-284.

Gunderman, R, and SL Kanter (2009), “Educating physicians to lead hospitals”, Academic Medicine, 84:1348-1351.

Horton, R (2008), “The Darzi vision: Quality, engagement, and professionalism”, The Lancet, 372:3-4.

Pope, DG (2009), “Reacting to rankings: Evidence from ‘America's Best Hospitals’”” Journal of Health Economics, 28:1154-1165.

Schneider, EC, and AM Epstein (1998), “Use of public performance reports”, Journal of the American Medical Association, 279:1638-1642.

Smith, SK (2009), “The value of Academic Health Science Centres for UK medicine”, The Lancet, 373:1056-1058.

Stoller, JK, E Berkowitz, and PL Bailin (2007), “Physician management and leadership education at the Cleveland Clinic Foundation: program impact and experience over 14 years”, Journal of Medical Practice Management, 22: 237-42.

Joenz: So to you,pharmacy starts n ends with drug dispensing right?hence,all they do is sell products and the laboratory,biko which products do they sell in the laboratories.You see if I were you,I will limit myself to what I knw and join ma brother Zeus to tenaciously push for the privatization of the wards since I'm sure it will benefit the physicians a whole lot more.Physicians,leave other professionals alone to determine their individual fate and face yours.if privatization is d new toga,ask for the privatization of your dept n leave others to determine what happen to theirs.The earlier u realise that d hospital isn't the physicians estate whr everything must b structured to suit u,the better for the sector as a whole.

as long as it continues to be called an HOSPITAL and not a pharmacy,laboratory or a gymnasium, then d medical doctor would continue to b at the forefront of care. Allied health workers are meant to assist the doctor just like a court bailiff would a judge.... If the medical team becomes conviced that it would function better if the people meant to be of assistance are privatized Ofcourse govt would heed to that.

allycat: Sister not brother

oh my sister please pardon me. If u had placed a ms/mrs beside allycat I would Hv had a clue

allycat: Ok. Hope you are ahving as much fun as I am on nairaland. It's amazing to see the mindset of people we work with and being anonymous they can tell you what they really feel and you can do the same without the need to be dignified about it.

lol ... My brother I am o . None of their write up has surprised me thus far tho. Had always known these enimities existed even while an undergraduate . Imagine wen i heard the psn president (akintayo) speak all he reminded me of was student politics