There are a number of important people in the hospital to whom a person wanting to see the ‘chief in a hospital may be led to.
He could be led to the chief physician, or the office superintendent, or the medical superintendent, or the secretary of governing board, to mention a few.
Most organisations have a chief, who is in charge of everything that goes on there. But who controls the hospital’s activities and services?
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There appear to be several people and several groups who all have something to do with controlling the above activities, but no single person or group appears to be in- charge of the whole set-up.
The administrator, on the other hand, if asked as to what goes on in his office, might go so far as to say that it is the place from where the hospital is “run”.
Excepting, a single-proprietorship hospital, there has to be a body of persons statutorily responsible for running the hospital. This body is variously called the “board of directors”, “governing board”, “board of trustees”, “governing body”, or “management board”.
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Can a group of persons say the board of trustees or governing board is effectively in-charge of the hospital’s administration? To answer this question, one has to understand how such a board functions.
A governing board, as a body of persons, can make and guide policy but cannot; by its varying composition, “run” a hospital.
This task is carried out by the hospital administrator. As the board’s chief executive officer he has overall charge of the affairs of the hospital.
However, the extent of his control depends upon the following factors.
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1. How he perceives his job.
2. How the board perceives the job.
3. How much freedom he is allowed in doing the job.
A typical hospital management board (or Board of Trustees or Board of Directors) is scarcely different from many other dissimilar organisations. Some boards may interpreted their own role as of “running” the Hospital’s day- to-day affairs.
On the other hand, the administrator could be inhibited from showing his initiative. In the first instance, the general calibre of the administrator who is reluctant to assume responsibilities may be the reason for the Board’s interpretation.
In the second instance, the board itself may be unwilling to give him scope to do so. In certain hospital organisations, there is a failure to recognise the distinction between the role of the board and that of the administrator.
These results in over deliberation by the board, with trivial matters being debated in board meetings and the administrator reduced to an onlooker.
On the other hand, there are well run hospitals in which competent administrators have been allowed to take effective control, and the board understands that its own function is only to determine how it should be run.