Doctor-managers as decision makers in hospitals and health centres.
OBJECTIVE
This paper describes factors influencing doctor-managers' decision making in specialised health care, health centres and at different levels of management.


METHODS
Data were collected as part of a survey on physicians graduating in 1977-1991 as drawn from the register of the Finnish Medical Association. The study sample was formed by selecting all physicians born on odd days (n=4144) from the baseline group (n=8232). The category of doctor-managers comprised physicians reporting as their main occupation: principal or assistant principal physician of hospital, medical director or principal physician of health centre, senior ward physician of hospital, and health centre physician in charge of a population area.


RESULTS
Independent of gender, all doctor-managers responding to the survey reported that the most important base for decision making was personal professional experience. Position in organisation (first-line manager, principal physician) had no impact on the base of decision making. Doctor-managers in primary health care utilised knowledge on norms and knowledge available from their organisation in support of their decision making to a greater degree compared with doctor-managers in specialised health care.


CONCLUSIONS
Evolution discourse from public administration is not yet receiving much response in Finnish doctor-managers' activities, instead, they still act as clinicians.


CONCLUSIONS
Facing the growing challenges of the future, the paper shows that doctor-managers should reconstruct their orientation and to act more like managers.
Elina
Viitanen
V
School of Public Health, Tampere University, Tampere, Finland. elina.viitanen@uta.fi
Juhani
Lehto
L
Tiina
Tampsi-Jarvala
TJ
Kari
Mattila
M
Irma
Virjo
V
Mauri
Isokoski
I
Harri
Hyppölä
H
Esko
Kumpusalo
K
Hannu
Halila
H
Santero
Kujala
K
Jukka
Vänskä
V
D000328:Adult; D001291:Attitude of Health Personnel; D003659:Decision Making, Organizational; D004503:Education, Medical, Graduate; D005260:Female; D005387:Finland; D017144:Focus Groups; D006739:Hospital Administration; D018578:Hospital-Physician Relations; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D008486:Physician Executives / Q000193:education / Q000458:organization & administration* / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration*; D011361:Professional Competence; D011795:Surveys and Questionnaires