Study finds top-ranked hospitals typically run by physicians
indings published in Social Science and Medicine report that the top-performing hospitals are typically led by physicians rather than non-physician managers.
The conclusions run counter to modern trends in the western world that place generally trained managers — rather than those with medical degrees — at the helm of hospitals.
“Over the last few decades, there has been a growing tendency for hospital boards to appoint managers as CEOs,” report author Amanda H. Goodall, PhD, explained in a release. “These findings raise some warning signs over that trend … according to the latest data, outstanding hospitals tend to be those run by somebody with a medical degree. I was surprised by the strength of the pattern.”
Goodall’s study involved collecting data on the top 100 U.S. hospitals in 2009 as identified by the US News and World Report’s “Best Hospitals” ranking across several categories. The ranking originally listed 50 hospitals in each category, so the other 50 in each category were put together through analysis of US News and World Report’s grading system as applied to the remaining hospitals.
Data on each hospital’s CEO were obtained through hospital websites and, in some cases, personal contact with relevant institutions. CEOs were categorized as either physician-leaders or leaders who arenon-physician managers. The study used obtainment of a medical degree as a measuring point for which CEOs qualified as physician-leaders. Goodall reported three nurses were among the CEOs in the cohort — these individuals were categorized as non-physicians.
The results of the study reportedly show that hospital quality scores are approximately 25% higher in physician-run hospitals than in those run by non-physician managers.
Goodall stressed that although the results point toward better hospitals being run by physicians, more research is needed before cause-and-effect can truly be understood.
“This paper does not establish that physicians make more effective leaders when compared with professional managers; but it starts the empirical process,” Goodall wrote. “It finds … that hospitals positioned higher in the US News and World Report’s ‘Best Hospitals’ ranking are led disproportionately by physicians.”
“This is an intriguing pattern but these snapshot results for a single point in time do not prove that doctors make the best heads of hospitals, although they are consistent with that claim,” she added. “More research following a range of hospitals through time is urgently needed.”
- Goodall AH. Physician-leaders and hospital performance: Is there an association?Soc Sci Med. 2011. doi:10.1016/j.socscimed.2011.06.025