1. From Professional to Managing Professional The start of a research project 1

2. Professional Service Firms (PSF)  David Maister (1993)  Law Firms, Accountancy Firms, Consultancy Firms, Hospitals, Universities, etc.  Knowledge intensive, autonomous professionals, deliver services  Ownership, management and production combined  Career mobility: up-or-out, levels of seniority, partnerships

3. Facts & figures Hospital sector  243 employers  324.200 employees  4,3% of total number of employees in The Netherlands  Approximately 16.000 physicians  75% self employed / 25% employment  Expenditures on national health care 9,2% (2004)

4. Health organizations (1)  Hospitals  Power of organized occupational groups  Separation between professional and administrative zones of control  Lay control over professional discretion inappropriate (professional staff to police the performance of its members)

5. Health organizations (2)  Nonetheless - …. Change & Overlap:  Market reform: insurer-provider relationships led to common goal professional and administrative management  Board of directors and medical staff responsible for quality and reputation hospital  Need for physician involvement in managerial decisions  Physicians become managing professionals

6. Quotes

7. From Professional to Managing Professional  Residents  Basisarts  AIOS/ANIOS: assistent (niet) in opleiding tot specialist  Physician/Consultant  Medisch specialist  Managing Physician or consultant (Chief of Staff, Director of a clinic, chairman of the department)  Medisch manager

8. From Professional to Managing Professional  From Physician to Managing Physician  Usually they become a manager without:  Any managerial experience  Any learning or management development  Knowing whether they have what it takes  Mainly because: … It was my turn … & somebody has to do it …

9. Competency profile physician Royal Dutch Medical AssociationRoyal College of Physicians and Surgeons of Canada

10. 10 Managing Professional (House M.D.)

11. 11 ASSIGNMENT Design the research project

12. Assignment: From Professional to Managing Professional Assignment: work in subgroups (6 or 7 each), take 30 min. to discuss, present (each 5 minutes) 1.Designing the problem and research questions  What would you say is the problem that we are seeking to improve?  Problem definition, using different perspectives / each other  What are the research questions? 2.Theory  “Nothing is as good as a practical theory” (Kurt Lewin)  Relevant theories and suggestions for variables to include in the study

13. Who’s interested?  Several hospitals: Canisius Wilhelmina Ziekenhuis, St. Antonius Ziekenhuis, Alysis Zorggroep, Medisch Centrum Haaglanden  How about you?