Managing a hospital without prior knowledge of medicine may be difficult. To provide a high standard of health care services, administrators must acquire the right mix of principles and practices common to any managerial position. Management in the health industry is difficult because; defining output is difficult, the complexity of the services involved as comparing to other sectors. Hospitals deal with emergencies; therefore, it cannot be deferred. The consequences of error are severe; therefore, a need for a high level of coordination as different units of the hospital is interdependent. The doctors, nurses and other medical professional are devoted more to the profession than to the organization. Administrators have extremely little power over clinicians whereas; this is the group that generates the bulk of work and expenditure.
The above challenges demand a person of exceptional charisma, shrewd in negotiations, and with a medical background. This study aims to find out if hospitals that are run by administrators with a medical background perform better than those ran by administrators without a medical background.
In health providing organizations, managerial complexity is shown in areas organizational relationships, a greater need for technical knowledge, and difficulty in resolving problems. A health administrator’s job is complicated by many factors (Baumol et al 1982) The following are the factors that affect the administrators.
•An active medical school, which brings in logistical and political complexities. The administrator has to maintain a system that integrates the residents, students and consultants harmoniously.
• Community relationships
Hospitals do not deal with one group in a population, but could be a deal with different demographic groups at the same time, and the administrator has to be skilled to deal with any shortcomings that might arise in such a situation
• Inpatient workload
A large inpatient workload will demand an increase in the staff availability to handle them. The administrator has to ensure that the hospital is well staffed, resources are in a proper working condition, and maintenance and replacement are done when necessary.
• Ambulatory care work load
This is especially troublesome in older facilities, which came up before there was a significant emphasis on ambulatory care as there is now. Ambulatory services have fluctuating demand making resource allocation difficult to the administration.
• Medical specialties
A hospital that deals with a diverse range of specialties must have the skilled personnel to provide those services. These specialists are few, and there the administrator has to do several refreshers and retaining courses. Other challenges that medical specialties raise are the demand for drugs, equipment and space.
• Medical research
Resources have to be diverted from patient care to the research project leaving the administrator with the problem of conducting an analysis on of the costs and benefits, to evaluate the feasibility of the project. Research projects also demand extra space, equipment and staff not to mention the need to maintain the separate set fiscal management procedures.
• Geographical location
In highly isolated areas, the administrator would have to provide amenities that would have otherwise been provided by an independent contractor. These include amenities like water treatment, sewage disposal and fire-fighting equipment. On the other hand, an administrator whose hospital is located in the inner city will have security problems consequently making retention of personnel difficult.