提上来，医生关于什么的内行？

问题多

医生是负责看病的，是治病的内行。但是，医生是不是医疗体系资源管理的内行？

据我所知，医院资源利用的规划和管理在多数国家都是专业的管理和财务人员在做。除非某个医生被认为有管理能力才会成为医疗体系的管理者，想走管理这条路的医生多数都得去拿个卫生管理和规划的学历才行。除了中国有些医院的医生，有几个国家的医生能亲自干预卫生体系的资源分配的？

英国负责医疗资源分配的是财政部和卫生部，那里的人都是经济学、会计学和社会服务规划学科出身的。英国NHS的经理是学历史和政治出身的公务员；新西兰卫生规划的部长是银行信贷管理出身的。


为什么会这样？恰恰是和我前面说的一样：医生的出发点和社会不一样。医生恨不能不受任何财务限制尽情地治病救人。但是社会是要把有限的资源尽可能高效率、高效果地花出去。所以任何国家的卫生制度都是不断地改革，不断地调整的，目的就是为了控制医疗费。除了不死人以外，医院的资源分配怎么合理取决于财务方面的标准，分配得是否公平取决于公众共识。医生的意见只能是达成共识过程中的参考，但是医生从来不是社会服务公平标准的制定者。

即使不说医院，咱们看看大学，大学的资源分配不是教授决定的，而是行政和财务部门根据供求情况分配资源。这些部门的人都不是教书匠。如果有人跟我提出的教育资源分配不公的具体现象，并且说这个制度不公平，我作为一名大学老师，我只能说制度的安排是这样，我支持这个制度；或者我对公平的认识可能和你不一样，所以我不同意你说的。但是，最终判断一个制度是否公平，或者是否应该继续下去，是由专业管理人员和社会公众来做，而不是教师。教师最多只能呼吁。因为我比你懂怎么教书，所以你的说的现象即使明摆着发生了我也可以说是不存在，或者我的公平标准才是对的。这有悖常理啊。

南云

医生关于什么的内行>>人的身心健康的干活．

问题多

医生关于什么的内行>>人的身心健康的干活．
南云 发表于 2011-11-22 22:20

   所以就不一定是财务管理和资源分配的内行么。

jimbo

所以就不一定是财务管理和资源分配的内行么。
问题多 发表于 2011-11-22 23:17

    除非是个人开的小诊所

问题多

除非是个人开的小诊所
jimbo 发表于 2011-11-23 11:35

   个人的诊所公平性的标准确实可以医生自己定，别人当然不能说什么。但是，他不能不考虑病人用脚投票的作用。

澳洲大头

看不懂，飘过。。。。。。

大家拿

医生是负责看病的，是治病的内行。但是，医生是不是医疗体系资源管理的内行？

据我所知，医院资源利用的规 ...
问题多 发表于 2011-11-22 08:36

医院的CEO和DCEO都是啥人做？

社员甲

医院的CEO和DCEO都是啥人做？
大家拿 发表于 2011-11-23 19:52

我们这里医院的新CEO是从苏格兰找来的，她是护士出身，……

问题多

医院的CEO和DCEO都是啥人做？
大家拿 发表于 2011-11-23 19:52

看看牛津The Oxford Radcliffe Hospitals 医院总经理：
   Previously Chief Executive at the Dudley Group of Hospitals NHS Foundation Trust, Paul has some 40 years of experience in healthcare finance, management and leadership.A qualified accountant, he has been Chief Executive in three NHS Trusts over the last 20 years, where he has led large scale organisational change.

再看看美国的：

Introduction to Healthcare Executive Careers:
If you’re seeking a highly compensated role in healthcare that doesn’t require a clinical or medical degree, working your way up to a healthcare executive or hospital executive role could be a great option for you. Hospital executives and healthcare executives come from a variety of backgrounds, many of which are non-clinical. Below are some examples of healthcare executive roles.
Hospital Executives:
Each hospital has a team of executives responsible for the optimal, efficient operation of the facility.

• Chief Financial Officer: Background in Accounting or Finance. The CFO manages, tracks, and oversees all of the financial operations of the hospital.
• Vice President of Human Resources: The VP of HR oversees all of the personnel and hiring.
• Chief Information Officer, or Chief Technical Officer – These hospital executives have a background in IT (information technology)
• Chief Executive Officer: Hospital CEOs can come from a variety of backgrounds, including business, consulting, operations, medicine or more.

这些都说明，医院的资源分配并不是由医生直接做的。医生当然也有可以做CEO，这也是为什么我们的卫生经济和管理专业有那么多在职的医生来学习。他们确实懂得看病，我们的老师没有会看病的，但是要判断医院的钱是否花得是地方，需要的是经济、管理和会计方面的专业知识。

问题多

我们这里医院的新CEO是从苏格兰找来的，她是护士出身，……
社员甲 发表于 2011-11-23 20:35

  你再仔细看看，她是不是后来又获得了医院管理方面的资历？这种例子不是没有，但是太少了。

社员甲

你再仔细看看，她是不是后来又获得了医院管理方面的资历？这种例子不是没有，但是太少了。 ...
问题多 发表于 2011-11-23 20:52

没提到。

Her early career included accident and emergency nursing for more than 10 years in the Glasgow area and in the Middle East, in Saudia Arabia and Oman.

Later, she sought senior nursing posts and then management positions, going up through the management ranks, taking on her first chief executive role in 2002 at an acute hospital in Kingston in southwest London.

Asked about her move into management, Ms Heatly said she was always aware as a nurse that the "message got diluted as it went up".

"I'm still aware of that, still conscious that it is really really important to hear what staff have to say. Staff actually deliver the care."

********************************

Carole is passionate about the NHS and has experience of it from all sides. She began her career as a nursing assistant in a maternity hospital, before becoming a general nurse and then caring for sick children in Edinburgh. As well as working out in Saudi Arabia and Oman, Carole worked in a tough A&E department in Glasgow as a sister for many years before moving into management over 15 years ago.

************************************

Senior doctors had been privy to the CEO appointment process, and were extremely impressed by Ms Heatly, he said.

Although Ms Heatly worked mainly in England, her Scottish background was promising because that country's health sector was known for strong clinical networks and her background in nursing suggested she would understand patient and staff needs, he said.

New Zealand Nurses Organisation organiser Lorraine Lobb was pleased a former nurse had been appointed, although she said that in itself did not guarantee good management.

UWB

看不懂，飘过。。。。。。
澳洲大头 发表于 2011-11-23 19:39

    +1...

柞里子

你再仔细看看，她是不是后来又获得了医院管理方面的资历？这种例子不是没有，但是太少了。 ...
问题多 发表于 2011-11-23 20:52

米国某些商学院有卫生行政MBA。我之北京时见过一个，U Penn 的。
那时候国人搞不清这些事儿，不少人纳闷他又不是学医的，凭什么想在卫生部门当高官。

大家拿

看看牛津The Oxford Radcliffe Hospitals  医院总经理：
   Previously Chief Executive at the Dudley  ...
问题多 发表于 2011-11-23 07:48

得，全是外行，所以存在那么多问题。。当然问题总是会有的，不管外行管还是内行管，但内行管总比外行管好得多。嘿嘿。 我们的CEO是资深医生，科头，后来进入院领导层多年，并有MBA。DCEO原来是护士，后来是院总护士长，也在院领导层工作多年，也有MBA。这叫内行领导内行。

柞里子

得，全是外行，所以存在那么多问题。。当然问题总是会有的，不管外行管还是内行管，但内行管总比外行管好 ...
大家拿 发表于 2011-11-24 09:19

我一向主张外行领导内行。嘿嘿
内行当领导，无论那内行是真是假，都没活路。
真内行，你斗得过？
假内行，那就更别提了。
只有名正言顺的外行当领导，日子才好混嘛。