Roles, attributes and career paths of medical administrators in public hospitals: survey of Victorian metropolitan Directors of Medical Services

Abstract

Aim. To document the roles, the perceived skills and attributes and experience required of Medical Administrators in contemporary public hospitals. Method. Interviews with Directors of Medical Services (DMS) from Victorian metropolitan public hospitals between March 2005 and May 2005. Results. A total of 14 of the 21 DMS in Victoria were interviewed. Key roles: Managing Medical Staff; Clinical Governance and Quality Improvement; Strategy and Service development; and Medical advisor to CEO. Key attributes and skills aligned with roles. Most respondents hold Fellowship of Royal Australasian College of Medical Administrators (FRACMA) with over half employed for less than 2 years. Discussion. Core roles identified mirrored in key international literature. Recommendations for further study includes systematic review of literature; the influence of the medically-trained Chief Executive on roles; and further analysis of high turnover. Conclusion. This study clarifies the roles undertaken and skills required by Medical Administrators in contemporary public hospitals, providing: (1) role benchmarking for Chief Executives; (2) reduced ambiguity among the broader medical staff of the roles, to assist those who may need Medical Administrator assistance with providing patient care; (3) assisting the Medical Administration profession and RACMA to provide tailored education and training; and (4) to inform aspiring future Medical Administrators of the broad nature of such roles. What is known about the topic? There is little current Australian literature surrounding the roles and skills and experience required of Medical Administrators in Director of Medical Service positions within contemporary healthcare organisations. The roles are often poorly understood by the greater medical profession and other health professionals. This study provides clarity around the current roles and skills and experience required. What does this paper add? This study illustrates the key roles for Medical Administrators in contemporary public hospitals as (1) Managing Medical Staff (2) Clinical Governance and Quality Improvement (3) Strategy and organisational service development (4) Clinical and Medical advisor to CEO. This study also highlights the key attributes and skills that reflect the needs of the roles, with most respondents holding a Fellowship of the Royal Australasian College of Medical Administrators (RACMA). In addition, there is a high turnover with more than 50% having been in the roles less than 2 years. What are the implications for practitioners? This study clarifies the roles undertaken and skills required by Medical Administrators in contemporary public hospitals. This study (1) assists Chief Executives to benchmark appropriate roles for Medical Administrators in their hospital (2) reduces ambiguity and increases awareness amongst the broader medical staff within a hospital of the roles of a Medical Administrator. The medical staff often need to access the skills of a Medical Administrator to assist them with providing patient care (3) assists the Medical Administration profession and RACMA to tailor education and training for such roles and (4) provides aspiring future Medical Administrators with an understanding of the broad nature of such roles in hospitals.