Affiliations: [a] Department of Anaesthesiology and Intensive Care Medicine, COLLM KLINIK OSCHATZ, Oschatz, Germany
| [b] Department of Psychology and Sociology, University Hospital Leipzig, Leipzig, Germany
| [c] Department of Orthopaedics, Traumatology and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
Correspondence:
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Address for correspondence: Joerg Schnoor, Department of Anaesthesia and Intensive Care Medicine, COLLM KLINIK OSCATZ, Parkstr. 1, 04758 Oschatz, Germany. Tel.: +49 03435 94 1601; Fax: +49 03435 94 1603; E-mail: jschnoor@collm-klinik-oschatz.de.
Abstract: BACKGROUND:Management by Objectives (MbO) has been shown to establish efficient team work in both industry and medicine. Its most important prerequisite for success is target agreements between managers and medical professionals on equal footing. In medicine, lump-sum financing urges the delivery of a health care service with minimal effort. Consequently, daily clinical life changed, with economic goals seeming to become priority over medical principles. OBJECTIVE:To determine how well MbO can still be practiced in hospitals with lumped treatment prices. METHODS:We used an anonymized questionnaire for already retired physician executives who completed their active leadership positions between 2010 and 2015 in Saxony (Germany). We asked various type of target agreements that had been used in order to achieve medical or economic targets. RESULTS AND CONCLUSIONS:Out of 111 former executives, the questionnaires of 25 respondents could be analysed. Eight respondents confirmed target agreements that were mostly set by managing directors. If used, most targets had not been adapted to the infrastructure and personnel strength, nor were they coordinated with neighbouring departments. Four respondents received financial incentives. Most medical executives were unsatisfied and preferred to abandon further goal setting. Due to the low number of cases, the representativeness of the study is limited. Nevertheless, it might be questioned if a flat-rate remuneration system facilitates the change into an authoritarian leadership concept.
Keywords: Hospital management, economics, targets, Management by Objectives, financial incentives
