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Lise Schleiss & Helle Mahler

Student thesis: Master executive thesis


The roles of head of department and consultant have changed along with the introduction of management actions into the Danish Hospitals taken primarily from New Public Management. Focus on operations and finances are being paid much more attention than before. There are many stakeholders who each have their legitimate right to claim that their particular interests are met, or that they at least be involved in decision making. During the same period of time recruitment problems have developed to fill the vacant positions of head of department. Research has claimed, that the consultants are part of the problem because they refuse to accept the new ways of managing the hospitals and confront the head of department with their discontent. The head of department experiences to get his legitimacy in the medical group through his professional skills and much less through his general management profile. In this paper we will look into how the consultants experience management from a legitimacy perspective. For this analysis we use theory by Mark Suchman. We will also study which parameters are considered to motivate the consultants to apply for the positions of head of department. Regarding this analysis we will use motivation theory by Richard Ryan and Edward Deci. We have conducted two focus group interviews with consultants participating from two hospitals in the region of Copenhagen and Zealand. We were interested in their narratives and expected that a qualitative study approach would give the doctors the opportunity to reflect upon and refine their answers. We find that the consultants primarily focus on the medical skills of the head of department as legitimacy rewarding. They cannot respect a manager who is not a doctor. The consultants recognize that there is a need for leadership and management and that the medical competences alone are not sufficient to lead a department. The consultants experience that the autonomy of the position of head of department is very limited and that the workload is heavy. Furthermore they do not find the tasks that lie within position interesting and therefore they are not motivated for applying for the positions. 3 We conclude that presently the position of head of department needs to be redefined. This implies that the consultants need to acknowledge that the position of head of department also includes operational and financial responsibilities besides medical issues. They also have to understand their responsibility regarding implementation of new medical procedures, education etc. in respect of the economic and organizational situation. However hospital managers need to understand the difficulties involved in the position of head of department and recognize their responsibility by being supportive and ensure that the tasks of the position are made attractive to potential applicants.

EducationsMaster of Public Governance, (Executive Master Programme) Final Thesis
Publication date2014
Number of pages64