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Thoughts

Doctors - Powerful People

20-February-2013
20-February-2013 0:00
in General
by Dr. Megan Joffe

Managers manage but the people with the real power are the doctors, nurses, care workers and of course the patients. Doctors think managers have all the power – and the Francis report demonstrated how cruelly and misguided the use of that power can be.  But it’s not as simple or as easy as that. Three levers of power are legitimate or position power, information and expertise (cf French & Ravens 1960). What managers have is position power - by virtue of their job title they have legitimate power; they probably have information power i.e. they know stuff (facts and data) that others don’t know or choose not to know - for example, the state of the financials, what the SHA/CCG or today’s equivalents are thinking about and what the DH is setting out to achieve. Doctors have expert power – the medical knowledge and skill they possess affords them expert power; their relationship with patients means their personality plus their expertise gives them power in the patient relationship (notwithstanding the patient partnership approach). If doctors choose to they can have information power – most if not everything is transparent and freely available. More importantly doctors have the opportunity to have position power as well if they become medical managers – offering them legitimate power. Becoming a hybrid medical manager puts doctors at the forefront of managing their hospital – leaving the power to those who have only legitimate or position power is no longer an option.

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