The New Management Team. (Shared Management)‪.‬

A SPIRITED DEBATE CONTINUES ON THE MUTUAL roles of physicians and nonphysicians in the management and governance of health care enterprises. Much of the debate and the spirit in which it is conducted is the result of the "intrusion" of physicians in a management domain that has long been occupied and controlled by nonphysicians. This is most true in hospitals and other institutional settings and in the upper echelons of managed care organizations. It is less true in medical group practices, and, it seems to us, that makes the latter an ideal setting for testing a new form of shared management that will help to rid organizations of the confrontational and adversarial attitudes that have too long characterized relationships among managers and clinicians in our health care organizations and institutions. The opportunity to jettison past attitudes and relationships is advanced by the emergence of a new breed of physicians, with outstanding clinical credentials and knowledge of and interest in the larger issues of management and policy. The success of these new physician specialists, and of the organizations they serve, can only be achieved if nonphysician managers acknowledge the important role of clinical decision-making in overall organizational operations and if clinicians accept the cost of a physician colleague's elevation to a management role.