I am not an engineer. If you asked me to build a bridge I would have no idea where to start. Engineers build bridges. That is what they are educated and trained to do – and Canada’s engineers build the best bridges in the world.
But as a manager I can tell the engineer where to build the bridge; when to build the bridge, how much money he has with which to build the bridge; and so on. The manager also provides the engineer with the men and material with which to build the bridge.
The same with healthcare. Do not ask me to perform a medical operation, or administer chemotherapy, or provide you with a differential diagnosis. I cannot do that. That is the job of a doctor and his allied health professional staff.
But the manager in healthcare should be able to – must be able to – provide the doctor with the space and technology to perform that operation; tell him how much money he has for it; and provide him with what he needs to do the job.
Both the bridge-building engineer and his manager must be left alone to do their jobs but also they must collaborate to get the job done on time, to specifications, safely and soundly so that the trains, trucks or cars can cross the barrier spanned by the bridge to keep the economy moving.
Same in healthcare; managers and doctors both need the autonomy to do their jobs, while working together in the best interests of the patient. Autonomy and collaboration are not mutually exclusive but complementary in achieving high performance amongst professionals.
Let the doctors do what they do best; and let managers manage.
What is the role for government in all of this? Well they are the payor so they are the customer. The customer ordered the bridge and paid for it only when satisfied. So government should set expectations, hold doctors and managers accountable to those expectations, provide them with what they need and no more, and get out of their way.
D. Wayne Taylor, PhD, recently retired from McMaster University, serves as the Executive Director of The Cameron Institute, a not-for-profit think tank specializing in health, economic, and social issues.