The hierarchy of work pursuits of public health managers.
How public health is managed in various settings is an important but under-examined issue. We examine themes in the management literature, contextualize issues facing public health managers and investigate the relative importance placed on their various work pursuits using a 14-activity management model empirically derived from studies of clinician-managers in hospitals. Ethnographic case studies of 10 managers in nine diverse public health settings were conducted. The case study accounts of managers' activities were content analysed, and substantive words encapsulating their work were categorized using the model. Managerial activities of the nine public health managers were ranked according to the number of words describing each activity. Kendall's coefficient of concordance yielded W = 0.710, P < 0.000, revealing significant similarity between the activity patterns of the public health managers. A rank order correlation between the activity patterns of the average ranks for the public health sample and for the hospital clinician-managers (n = 52) was R = 0.420, P = 0.131, indicating no significant relationship between relative activity priorities of the two groups. Public health managers put less emphasis on pursuits associated with structure, hierarchy and education, and more on external relations and decision-making. The model of hospital clinician-managers' managerial activities is applicable to public health managers while identifying differences in the way the two groups manage. The findings suggest that public health management work is more managerialist than previously thought.
Braithwaite
Jeffrey
J
Centre for Clinical Governance Research, Faculty of Medicine, University of New South Wales, Sydney, Australia. j.braithwaite@unsw.edu.au
Luft
Sabine
S
Bender
Wolfgang
W
Callen
Joanne
J
Westbrook
Johanna I
JI
Westbrook
Mary T
MT
Mallock
Nadine A
NA
Iedema
Rick
R
Hindle
Donald
D
Jochelson
Tanya
T
D000884:Anthropology, Cultural; D001315:Australia; D003151:Community Health Centers / Q000458:organization & administration; D003659:Decision Making, Organizational; D004651:Employment; D006608:Hierarchy, Social; D006801:Humans; D007587:Job Description; D017146:Models, Organizational; D019982:Organizational Case Studies; D024382:Professional Role; D011635:Public Health Administration / Q000193:education / Q000379:methods