Firstly, they believe that medicine is geared more to curing than caring. The nature of medical practice is interventionist. Management is about continuous care over operations and strategy of the organisation more than intermittent, specialised, and radical cure.
Secondly, physicians are trained to make decisions individually and decisively, whereas managers often have to meet with others to come to a collective decision. When a doctor sees a patient, a decision must be made, even if it is to do nothing for the moment. Except for complicated cases, a medical panel may meet to discuss the complex issues and this is not the norm.
After recovering from a robotic operation by a vascular specialist to insert a stent in my artery, I was told by an assistant surgeon that there were problems during the operation. When I later asked the chief surgeon about this incident, he avoided giving a direct answer but simply said: “All operations are complex otherwise you won’t need specialists with years of training to do the job—any layperson can do the operation.”
Thirdly, Mr Mintzberg et al 2 noted that “much of medicine is about parts, not the whole. Few physicians these days treat the entire person. Organisations need to be treated holistically”.
In an article Why the Best Hospitals are Managed by Doctors 1, Mr James Stoller, Dr Amanda Goodall, and assistant professor Agnes Baker noted that two of America’s best hospitals, the Mayo Clinic and Cleveland Clinic are led by highly skilled physicians. They wrote that “when an outstanding physician heads a major hospital, it signals that they have walked the talk, and thus have earned credibility and insights into the needs of their fellow physicians”. Having spent their careers looking through a patient-focussed lense, physicians moving into executive positions might be expected to bring a patient-focussed strategy.
With an expert leader as captain, it may also signal to external stakeholders, such as recruits or patients, about organisational priorities.
On the local front, Raffles Medical Group has four physicians out of 11 board members. They are executive chairman Dr Loo Choon Yong, Dr Wee Beng Geok, Professor Lim Pin, and Dr Sarah Lu.
Another listed company, IHH Healthcare Berhad, have two physicians on its board. They are Dr Tan See Leong, managing director and chief executive officer, and Dr Lim Suet Wun, corporate chief operating officer. The group owns four hospitals in Singapore and 14 in Malaysia among others.
Of the six members of the board of listed Healthway Medical Group, none of them are physicians. The executive chairman of OUE Ltd, Dr Stephen Riady is a prominent business person.
From the above sampling, we see that the first two companies recognise the necessity of having directors with specialised knowledge of the healthcare industry on their boards and they are doing fine from the revenue point of view.
Healthway Medical Group prefers business people as board members but their profitability is not remarkable.
Dr Tan Gang Chiang, a dental surgeon, says: “I feel that a manager with a masters in business administration cannot communicate coherently with the doctors unless he or she has knowledge of anatomy, physiology, and other medical subjects whereas a physician can tap on his peers for the latest information.”