Should doctors become hospital directors?

Associate Professor, Doctor Tran Thi Trung Chien, former Minister of Health :

They must have specialized training in management and administration.

To become a manager, a physician must first receive training, guidance, and up-to-date information, especially specialized training in management and administration. Without these elements, it will be very difficult for a physician to manage effectively and, consequently, to successfully complete assigned tasks. Talent is also essential for management positions, as it is crucial. Some managers may not have extensive formal training, but they possess a keen aptitude for management and the ability to quickly and appropriately interact with society. Finally, appointments to management positions must be voluntary.

In recent times, the medical sector has faced numerous difficulties, both objective and subjective. Part of the problem stems from the management staff in the sector and hospitals, who are often afraid of making mistakes, working half-heartedly and superficially; some appointed individuals even resign. Legal obstacles related to procurement, bidding, joint ventures, partnerships, and the management and use of public assets are the biggest hurdles, hindering the progress of medical professionals. What needs to be done quickly now is to ensure transparency in healthcare institutions and policies. The Law on Medical Examination and Treatment (amended) has been passed by the National Assembly and will take effect on January 1, 2024, but if the implementing regulations are slow to be issued and there is no "emergency" or specific mechanism, things will remain stagnant.

Mr. NGUYEN CONG LONG, Standing Member of the Judiciary Committee of the 15th National Assembly :

We should pilot the hiring of chief executive officers.

Vietnam is one of the few countries that applies a dual-role management model. This means that directors of public hospitals are highly skilled professionals in their field, having risen through a long process of advancement from treating physicians to departmental managers. However, they lack formal training in hospital management and administration. This leads to shortcomings in the management of equipment, human resources, and infrastructure, resulting in lower quality of medical care and a lack of professionalism.

Authorities need to standardize the criteria for managerial positions in hospitals, alongside regulations on medical practice. Simultaneously, regulations on managerial personnel standards should be considered as a mandatory criterion in evaluating the quality of healthcare facilities according to global standards. We should pilot a system where public hospitals hire executive directors, replacing specialized medical managers with professional managers. Executive directors don't need to be medically proficient, but rather skilled in management. This aims to create a breakthrough, improve hospital quality, ensure transparency and efficiency in public hospital management in line with global trends, and most importantly, restore the sacred mission of doctors: caring for patients.

Dr. Nguyen Trong Hao, Director of the Ho Chi Minh City Dermatology Hospital:

The director of a public hospital must be a doctor.

Hospital directors today face both subjective and objective challenges and difficulties, such as financial autonomy, pressure to continuously develop professional skills, medical staff turnover, procurement of medicines, supplies, chemicals, and equipment. I completely agree with the regulation that the director of a public hospital must be a doctor, because a hospital is a special environment with unique management stakeholders such as medical staff, patients, and their relatives. Hospital administrators with practical experience in professional work will be better able to understand the capabilities, thoughts, and aspirations of staff and empathize with the pain and desires of patients. From there, they will manage the hospital better, provided they receive training and continuously improve their financial management, human resource management, and other soft skills to meet the increasingly demanding requirements of the job.

Mr. BUI VAN HA, 72 years old, Trung Liet Ward, Dong Da District, Hanoi:

Leaders don't necessarily need to be experts in their field.

The separation between professional expertise and managerial excellence in hospitals should have been established many years ago. A good doctor should focus solely on their professional work, treating patients; because achieving professional excellence requires a long process of learning and research to improve their skills, leaving little time for studying and learning about management methods. From the perspective of a doctor who has worked in military medicine, I would like to suggest that a good doctor should concentrate on dedicating their talent and abilities to providing excellent medical care to the people. If they are to lead a hospital, they don't necessarily need to be highly skilled professionally, but they must have a thorough understanding of legal regulations, not only in the medical field but also in other areas, and they need to be well-trained in state management, and even in business administration.

Mr. NGUYEN THANH LUAN, Patient at Cho Ray Hospital:

It shouldn't be a rigid requirement that the director must be a doctor.

As a citizen who benefits from and receives healthcare from doctors in many public hospitals, I believe we need to change the notion that hospital directors must be professors or doctors of medicine, or hold high academic ranks and degrees in the medical field. Clearly, this is happening in many hospitals, but we need to recognize that, from a professional standpoint, they are very skilled in patient care and the development of advanced techniques. However, in terms of management, they may not be doing as well in addressing issues related to economics, supplies, medicines, and equipment. Clearly, the shortage of medicines and medical supplies in many hospitals, besides legal shortcomings, also stems from the hesitation and fear of hospital leaders who are only experts in diagnosis and treatment.

To ensure a truly robust and sustainable healthcare system, the Ministry of Health should allow public hospitals to hire general managers, while the professional responsibilities should be handled by professors and doctors. If the regulation rigidly stipulates that hospital directors must be professors or doctors in the medical field, they will focus solely on managing and overseeing all aspects of the hospital, leaving little time for professional development to better serve patients.

Journalist BUI HUONG, Deputy Editor-in-Chief in charge of the Popular Science Magazine:

The director must be someone with experience in medical examination and treatment.

A hospital director should be a specialist in both medicine and business administration, but perhaps ideally a doctor with experience in medical practice, hospital quality management skills, a thorough understanding of relevant legal regulations, and additional training in business administration. They must receive supplementary management training, not just in human resources management, but also in economics and policy. Being a hospital director solely based on professional expertise is not enough. If a doctor is a hospital manager, they need not only professional expertise but also extensive management knowledge.

Mr. CAO VU LAM, 72 Tran Dinh Xu Street, District 1, Ho Chi Minh City:

Excellent expertise doesn't always guarantee a good managerial position.

In public hospitals, there should be a clear separation between management and professional expertise. Leaders need to be good administrators, know how to utilize their staff, and allow highly skilled and specialized professionals to focus on treatment, teaching, and research to serve the healthcare needs of the people. I've visited many hospitals and observed that the current medical examination and treatment procedures in public hospitals vary from place to place, concentrating many highly skilled doctors, but management remains disorganized, and in some cases, even weak. Therefore, to further develop the healthcare sector, I believe that the hospital director doesn't necessarily have to be a doctor; what's most important is someone with strong management skills. Appointing doctors as hospital directors is a waste, because a highly skilled professional has to handle administrative management, leaving no time for research and treatment. Technical expertise and management skills are two different things. Many people have excellent professional skills but may not be good at management.

Source: https://www.sggp.org.vn/thay-thuoc-co-nen-lam-giam-doc-benh-vien-post680293.html