Managing and Keeping Healthcare Professionals
by Professor Rene T. Domingo
Health care institutions, particularly
hospitals, need to be managed well to be viable
and achieve their social goals. Skilled
professionals and managers should provide the
needed leadership and strategic thinking to
effectively run these complex organizations,
which are characterized by scarce resources,
demanding customers, and high-pressure
environment. The health care industry, however,
will have to compete with other industries for
these talents as they are produced by the
tertiary education schools and universities.
Most medical school graduates eventually work in
health care institutions as their first jobs,
though some get employed in other industries.
However, few graduates outside medicine –
accounting, engineering, business management, -
are attracted to working in health care
establishments, especially hospitals. There are
three major reasons for this lack of interest:
Hospitals and other health care institutions,
running 24/7, are perceived as high-stress
working environments, where quality of life are
almost always compromised by regular overtimes,
night-shifts, double-shift assignments, and
week-end duties. Moreover, having to deal with
demanding patients and doctors add to the stress
from long and unpredictable working hours. In
fact, medical staffs, in spite of their training
to work extended hours, quit their jobs because
of burn-out. They either retire early or move to
less stressful industries. Non-medical staff
will certainly have much lower thresholds and
staying power.
Secondly, healthcare establishments are
usually non-profit organizations. Many are
religious and government run. Consequently, pay
is not competitive nor attractive. Hospitals are
not perceived as greener pastures to move to.
Talents cannot be lured with higher pay, because
most health care organizations, being
non-profit, do not buy the concept of recovering
return on investments from this premium pay.
Non-standard pay is considered disruptive in
this regulated industry.
Thirdly, there is very little career
opportunity in most health care institutions,
which have relatively flat organizations. In the
private corporate world, career runways are
longer with milestones such as assistant
managers, assistants-to, and several levels of
vice presidents to look forward to by aspiring
staff. These are absent in most hospitals, where
middle management is lean. After lower
management and department heads comes senior
management - the medical director, hospital
administrator, and the CEO. Top management in
hospitals is usually vacated only by old-age
retirement, seldom by incompetence or the
availability of younger talents in the pipeline.
Given these handicaps of health care
establishments, we still can find
mission-oriented professionals and individuals
willing to forgo opportunities offered by the
corporate world, and dedicating their working
lives to serving the sick and suffering.
However, most new graduates of tertiary schools,
particularly those from the non-medical fields
and sciences, may not be as socially-inclined in
choosing their first jobs. Given this universal
situation, health care establishments should
consider the following steps and strategies to
compete more effectively in the job market for
talents and skills:
1. Improve pay and incentives; benchmark with
other industries; link pay to performance, not
just to working hours, and years of service.
2. Design and develop a clear and attractive
career path for heath care professionals inside
the organization; regularly replenish senior
management posts with new blood.
3. Provide stock ownership options to
employees. While doctors in private hospitals
are usually stockholders, this privilege should
also be given to nurses and the non-medical
staff.
4. Provide regular training and training
opportunities to health care staff and
professionals.
Health care establishments will have to
invest not only in upgrading equipment and
technologies, but also in enhancing their
working environments if they are to remain
competitive, effective, and relevant.
Rene T. Domingo is a professor and management
consultant. Please send comments to rtd@aim.edu.
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