How and why doctors transition from clinical practice to senior hospital management: A case research study from Victoria, Australia

Background: Hospitals are large, complex organisations that require the involvement of all health professionals, including doctors. The literature discusses the value of having doctors in management positions. Doctors who work in senior hospital management roles have positions such as chief medical officer or chief executive officer. There is a need to understand why doctors transition from clinical practice to such senior hospital management positions. Aim: To address the research question using qualititative research methods:
How and why do doctors transition from clinical practice to senior hospital management?
Methods: This research gathered data in two stages using qualitative methodologies. The first stage was exploratory and utilised the convergent interview method. This method used purposeful sampling to select interviewees with appropriate hospital management expertise, qualifications and experience. The five interviewees included non-medical hospital managers and academics. The second stage was confirmatory and used the case research methodology. Fifteen interviews with medically qualified chief executives and chief medical officers from hospitals were conducted. In total, 20 in-depth interviews were carried out as part of this research. Patterns from these data emerged as a result of a rigorous content analysis.
Results: Findings highlighted that doctors take different paths in their journeys from clinical practice into hospital management but have transitions that are incremental, unplanned and opportunistic in nature, as part of a portfolio career. Doctors have different reasons for moving into management, including the wish to have a greater impact on larger populations. The influence of role models and mentors was also found to be a significant positive factor but the negative perception of management by other doctors was a barrier.
Conclusion: Employing hospitals, with the support of government and policy-makers, should implement recruitment practices, informed by these findings, to encourage more senior doctors to consider a career in senior hospital management. © 2012 Radcliffe Publishing.