Pero por los mejores. Los concursos deben ser abiertos. Pero deben tener administradores tambien.

Parece que esto es cierto pero solo cuando el director es el mas destacado en su profesion en su institucion : es decir como medico saistencial (por ejemplo es el que mejor opera, el que mas salva pacientes, el que sabe resolver la mayor cantidad de problemas, en resumen como dicen vulgarmente el que mas sabe, el mejor). Hay formas objetivas y subjetivas de medir estos perfiles. Pero eso no es suficiente. El mejor medico no solo es el que mas sabe. Generalmente el mejor medico tambien es el que mas disfruta de su profesion. Al que le gusta lo que hace. Y el medico que no  tiene vocacion de servicio a los demas dificilmente puede disfrutar su profesion que basicamente se trata de eso.No se trata de llenarse o coleccionar palelitos titulos certificados diplomas que ya se sabe que en Peru es muy facil. Lamentablemente en el Peru se ha estado utilizando este metodo para valorar a los medicos. La direccion de un hospital no debe ser paras aquel que solo esta buscando poder para autobeneficiarse. Hemos tenido sociopatas en la direccion de varios hospitales recientemente y antes tambien. Sociopatas que nos enganan haciendonos creer a nosotros y a la opinion publica que estan interesados en los pacientes, en mejorar la calidad de atencion de los hospitales pero solo estan interesados en autobeneifciarse. Usar el poder que les da la direccion para uso y beneficio  personal.

A esto tiene que ir unido tambien ciertas condiciones naturales de liderazgo, capacidad para organizar planear dirigir, visionar imnovar motivar y dar el ejemplo. Como pueden seguir los cirujanos a un cirujano que nunca opera. Como los clinicos a  un clinico que no diagnostica bien o se asusta con pacientes graves. Como pueden seguir a un medico que no delega, que no sabe trabajar en equipo.

Escuche hace unos anos a un primer ministro decir que no se podia dudar de la honorabilidad de cierto medico porque era un investigador internacional un cientifico reconocido. Claro que para ser un verdadero cientifico la persona tiene que ser honesta y decente. Pero ser cientifico o investigador o medico no es una carta de garantia de que la persona sea decente u honesta necesariamente. Los titulos academicos no purifican a nadie. Y podriamos citar muchos ejemplos en la historia de la medicina peruana recienteo no muy reciente.

Obviamente el director tiene que ser una persona honesta y decente. Tendria que pasar una evaluacion siquiatrica profesional y especializada  no solo para buscar sicosis neurosis como siempre se cree que cualquiera puede diagnosticar porque son problemas obvios generalmente.. Se tiene que buscar sociopatias. El sociopata acuerdense luce normal para la mayoria de la gente. Usted escucho a algun siquiatra reconocido decir que Montesinos era un sociopata?. No. Solo escuche a Pilar Mazzeti decir que Olivera lo era. Por supuesto que la mayoria  sino todos los politicos ni siquiera sabian de que estaba hablando.

 c mori

 

 

Pues aunque muchos no lo crean, si .

July 7, 2011, 1:36 pm

Should Hospitals Be Run by Doctors?

By TARA PARKER-POPE

Should an M.D. also be a chief executive?

Are the best hospitals run by medical doctors or business managers?

The conventional wisdom is that doctors should focus on patient care, and managers with a business or administrative background are better suited to running the day-to-day operations of a hospital. Among the nearly 6,500 hospitals in the United States, only 235 are run by physician administrators, according to a 2009 study in the journal Academic Medicine.

But now new research suggests that having a doctor in charge at the top is connected to overall better patient care and a better hospital.

The findings, published in the journal Social Science & Medicine, are based on a review of 300 top-ranked American hospitals in the specialties of cancer, digestive disorders and heart surgery. Amanda Goodall, a senior researcher at the Institute for the Study of Labor in Bonn, Germany, tracked the professional background of each hospital's chief executive and then compared the performance of physician-run hospitals with that of hospitals overseen by someone with a nonmedical background.

The study found that overall hospital quality scores were about 25 percent higher when doctors ran the hospital, compared with other hospitals. For cancer care, doctor-run hospitals posted scores 33 percent higher.

Dr. Goodall said the finding was consistent with her research in other fields, which has shown, among other things, that research universities perform better when led by outstanding scholars and that basketball teams perform better when led by former top players.

"I was surprised by the strength of the finding,'' Dr. Goodall said.

The research doesn't offer any evidence as to why doctor-run hospitals appear to post better results, but Dr. Goodall said it may be because doctors truly understand "the core business of health."

"Hence, they are more likely to better understand the conditions under which their fellow core workers — doctors and nurses — will function best,'' she wrote in an e-mail. "If a leader creates optimal working conditions for the core workers, then that is likely to create a more efficient organization."

The data, based on annual hospital rankings compiled by U.S. News and World Report, included only three hospital chief executives with nursing experience, so it's not clear how hospitals perform with a nurse executive versus a traditional manager.

Dr. Goodall also noted that spending time caring for patients puts doctors in a better position to make the hard decisions that a hospital administrator faces.

"M.D. C.E.O.'s are more likely to prioritize patients because patient care is at the heart of their education and working life as a physician,'' she said. "When it comes to making hard budgetary decisions or rationing choices, M.D. C.E.O.'s may be able to make more informed decisions."

The findings simply show an association between high hospital scores and doctor C.E.O.'s and do not prove that doctors make better leaders, Dr. Goodall noted. It may be that top hospitals are simply more likely to seek out doctor leaders, and top doctor managers seek out the best hospitals. However, the study notes that at the very least, the data show that the best hospitals appear to be choosing physician executives, while lower-ranked hospitals typically rely on managers with a business or administrative background.

Dr. Goodall said the findings run counter to the practices at many hospitals in the United States and Europe.

"I think the pendulum may have swung too far in the favor of managers," she said. "This is partially because business schools have become so prominent, as has the M.B.A. These qualifications are helpful, but it is possibly not enough just to have a management education."

 
 
 

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HEALTH   | July 07, 2011
Well: Should Hospitals Be Run by Doctors?
By TARA PARKER-POPE
Most hospitals in the United States are run by business administrators. But new research suggests that having a doctor at the top leads to overall better patient care and a better hospital.

 

---------- Mensaje reenviado ----------
De: Jorge Chirinos <jchirinosmd@yahoo.es>
Fecha: 8 de julio de 2011 01:09
Asunto: [SALUD_LORETO] Los hospitales deberían ser dirigidos por médicos?
Para: Promo 79 <sanfernando79@yahoogroups.com>, Salud Loreto LA FIRME <salud_loreto@yahoogroups.com>

 

Pues aunque muchos no lo crean, si . This page was sent to you by:  jchirinosmd@yahoo.es HEALTH   | July 07, 2011 Well: Should Hospitals Be Run by Doctors? By TARA PARKER-POPE Most hospitals in the United States are run by business administrators. But new research suggests that having a doctor at the top leads to overall better patient care and a better hospital. Copyright 2011  The New York Times Company | Privacy Policy