DISCUSSION

DISCUSSION

A Hospital is a complex organization and has all the attributes of an organization. But

there are many special features of management and administration which are not

visible in many other organizations and systems. Managing a hospital to serve its

purpose requires specialized knowledge and skills as also a proper frame of attitude.

Gone are the days when a skilled clinician or a person trained in business

administration could be expected to manage a hospital. Specialized courses are

available today. They run by the universities and management institutions. Such

courses of study help the student to specialize in this frontier area between medicine

and management. So, that they will be able to manage the hospitals effectively and

efficiently.

“Hospital is a heterogeneous organization with diversified activities, as stated by

Dr.Shameem Rizwana in India’s premier medical portal report in his case discussion

on 11-jul-07 (journal of the academy of hospital administration) where different skilled

persons and medical and non medical activities are present. So we can't stick for only

medical background person to study Hospital Administration .If we give proper

training and along with theory classes to provide practical exposure then every person

will be perfect. In Government Hospitals, Hospital administration professional

(medical and non-medical) person to be present for proper utilization of funds.

“Hospital being a labour intensive organization, to manage it is not the job of any

tom-dick and harry unless on has an insight into organizational behavior, emotional

intelligence and of course hospital requirements in relation to effective and efficient

patient care as commented by Dr Umakant in his discussion on 12-Jul-07 on hospital

administration in India’s premier medical portal report (journal of the Academy of Hospital
 DISCUSSION

Administration) All this can be found in well trained and qualified hospital managers only

and no problem if all that is in a non medico even. With all this, being a doctor is

always an added advantage. Well structured Hospital Administration programe is

definitely a need of the era especially when one intends to be a global player with

international accreditation”.

Hospital administration is concerned with general administration as well as to meet

the special needs for efficient functioning of a health care establishment. All the

theories and principles of public administration with some modification are required

to be applied for the administration of the hospital.

“In India health care administration is in the hands of people other than those who

belong to the professions. We have trained doctors, qualified in Hospital management

and Other Management streams. But there is no employment opportunity as neither

the Industries, nor the corporate hospitals want to give the type of salary they deserve,

instead find it to be a cheaper alternative to employ others to manage the hospitals”

says Dr.R.kapuria, in his discussion on hospital administration in India’s premier

medical portal report (journal of the Academy of Hospital Administration) says that

A hospital administrator is primarily a manager of resource. The success of the

hospital administrator depends on how well he or she organizes and utilizes the

available resources.

There is nothing like only one set of people will have all the required knowledge and

expertise to run medical institutions must educate both medical and non medical

professionals adequately and then give them responsibilities, He believe training is

more important than background education says Dr Poul S   in his case discussion on
 DISCUSSION

Hospital Administration    on 10-Jul-07 in India’s premier medical portal report on

case discussion, 

"A good doctor could be a good administrator, but a good administrator cant be a

good doctor" this what most of the corporate hospital thinks, morever they can

appoint a single person for both the jobs for cost containment says Dhileep in his case

discussion on hospital administration on 11th July 2007 . But what he feels is, if a

doctor concentrates on a patient he can’t concentrate in administration because it is

totally different, we can practically see in any many hospitals he could concentrate

either in administration or in medical field. Cost containment is necessary but the

hospital should also think that their purpose is achieved or not. Even government

could interfere in it and they could even bring a rule that for min 25 bedded hospitals

should have an administrator with a qualified degree, only then the Indian hospitals

could be streamlined and could provide better treatment for patients.

Requirement for hospital administrators should be first and foremost selecting only

the best candidates fit for being management professionals says Dr Prerna Vashisht in

India’s premier medical portal report on case discussion on hospital administration

on   10-Jul-07 This should include a proper screening of the candidate (medico or non

medico) which includes a fair and unbiased examination based on merit, serious

interview sessions by professionals and experts, group discussions, Aptitude tests to

identify the real strengths of the candidates who can be trained later. Industry is full of

examples of big achievers who had no great academic achievements but common

sense combined with vision and will and confidence to make a difference.

Hospitals of today need to be run by medical administrators for the simple reason that

we bring to the table a unique blend of both, medical & management skills which are
 DISCUSSION

essential to the hospital industry. Being doctors we are able to understand the

requirements of our clinical colleagues and are able to bridge the gap between the

clinicians and the management. Changes in the health industry in India are very

evident but the one thing that has remained constant over the years are the human

emotions that are attached to it and no one understands that better than us says Rahul

in India’s premier medical portal report on case discussion on hospital administration

on   10-Jul-07 

Today, the healthcare sector is patient driven focusing on quality care as stated by Dr

Ssp in India’s premier medical portal report on case discussion on hospital

administration on 11-Jul-07 . If doctors had all the management skills, such courses

would never have been started. The concepts of management, like any other industry,

can be applied to hospital as well. So the right person can be a hospital administrator

or the doctor until he applies his knowledge in the right direction. After all its hospital

management and not just clinical management!

The debate of who being a better hospital administrator either a medical person or a

non medical has been going on from ages and probably will go on forever, A medical

doctor with experience in clinical field and combined with a management degree is

the need of the hour. he blends in to the hospital environment and is the best position

to understand and handle the requirements and the problems faced by the staff who

are the blood line of the hospitals, and the purely management administrators are

suited and apt for dealing according to Dr Mayur   in India’s premier medical portal

report on case discussion on hospital administration on 13-Jul-07.

 DISCUSSION

Hospital administrator monitors physicians' performance with accurate data on

clinical outcomes and patient satisfaction says Turkan Oguzhan et al, So better-

educated administrative personnel give the better service and it causes client's

satisfaction. It is required to change hospital policy from quantitative process to

qualitative process and for quality management; hospitals ought to have six elements:

"Philosophy, Vision, Strategy, Skills, Resources and rewards".

[Turkan Oguzhan, Gurean Bebitglu, Yusuf Ustu : Hospital Administration Operations in Turkey: Journal of
the Academy of Hospital Administration Vol. 16, No. 2 : 2004 (07 -12)]

"A Hospital is a living organism, made up of many different parts, having different

functions, but all these must be in due proportion and relation to each other and to the

environment to produce the desired results" as stated by Dr. S. Billings: in his speech

made in 1889 on Hospital administration and planning.

[Dr. AG Chandorkar: Hospital administration and planning, pg, no: 32, 1st edition, 2005]

Finally the Hospital administration is more than institutional management, it is

general administration, business administration, health and medical administration all

combined together says Abad Ahmad.

So Proper administration of a hospital by a trained and experienced hospital

administrator would add the efficiency and effectiveness of a hospital.

[Abad Ahmad: challenges in hospital administration. Hospital administration 15(1): 1978.