The FINANCIAL — While job opportunities are decreasing in financial sectors because of the global crisis, perspectives for medical management students leave way for high hopes both in Georgia and the USA.
“Healthcare management today is the concern of everyone who is involved in healthcare delivery. High expectations of the public and ever-increasing pressures to provide value for money make the role of managing scarce resources more challenging than it has ever been. Effective management is just as vital for a hospital or clinic as it is for any other business, but managing a healthcare service is not the same as managing a factory,” Shota Davitashvili, Commercial Director of the Urgent Cardiologic Centre (UCC), told The FINANCIAL.
“In 2007-2008 we had 12 medical management students taking part in internships at our clinic and in 2009 we expect this number to double,” said Mr. Davitashvili.
According to the U.S. Department of Labour (DOL), Healthcare management jobs are likely to increase greatly as the U.S. population ages, both in number and in salaries. This also includes careers in healthcare such as administration and allied health occupations in which business skills are more important than a medical degree.
Early in 2007 the Georgian Government launched a nationwide programme of hospital sector restructuring “100 New Hospitals.” The goal of the programme was to transfer ownership of all state-owned, privately administered hospitals in Tbilisi and the regions to the private sector by means of direct sale. The project is still active.
It means that more and more vacancies will be available for managers in the health care sector in Georgia.
According to DOL forecasts most of the new wage and salaried jobs created over the next 5 to 7 years will be in healthcare management. Most of these workers have jobs requiring no more than an associate’s (two-year) degree.
“There was no such field of studies in Georgia as medical management. Today there’s increasing demand for business managers at the clinics. Ten years ago it was normal for the managers at the clinics to have been doctors. Now it’s changing and more people are needed in the clinics with actual business education,” Shota Davitashvili commented to The FINANCIAL
“Medical management takes place in a multi-professional organizational culture. It uses and develops knowledge about the way in which professionals and organizations function. The mission of management in healthcare is to enhance the way in which services are delivered and achieve the best possible outcome in terms of health benefits in a cost-effective way.”
The Urgent Cardiology Centre (UCC) was initiated in 1994 by Prof. Guliko Chafidze. The centre was created on the base of an Infarct Department, which was part of the Therapy Research Institute.
In 1995, in response to the economic crisis, the Government launched an ambitious health sector reform and introduced a new model for healthcare financing, combining tax subsidies, out-of-pocket payments and mandatory health insurance.
“After the USSR’s collapse and the transition of our economy to a market economy the only way to save our infarction department was by handling business analysis. In those years looking at medical service as a business was not so easy. At the beginning of the 90s Mrs. Guliko Chafidze risked and founded the Urgent Cardiology Centre, an independent legal entity. There was no funding at that time and it was very hard to transform medical service into a business,” said Shota Davitashvili.
On average UCC has 3,000 stationary and 7,000 ambulatory patients annually. According to the Commercial Director of UCC the revenues of the Clinic have been rising by 15% annually since 2006. Currently UCC has 181 employees.
In the past decade, the countries that emerged from the Soviet Union have experienced major changes in the inherited Soviet model of healthcare, which was centrally planned and provided universal, free access to basic care. The underlying principle of universality remains, but coexists with new funding and delivery systems and growing out-of-pocket payments.
DOL surveys indicate that healthcare was the nation’s largest industry in 2007, providing 14.5 million jobs nationwide. About 411,000 of these healthcare workers were independent, self-employed professionals. 40% of the fastest growing occupations consist of careers in healthcare. Such healthcare management jobs include traditional fields such as nursing and physician’s assistant, but can also include medical secretaries and home and personal home healthcare aides.
Most healthcare management jobs in the USA are in hospitals (over 44%). Nursing homes and residential care facilities make up the second largest source of employment, with private medical and dental offices a close third.
“Students or graduates who are interested in working in the medical field and are seeking a managerial position may choose to work in medical administrative services. Possible careers include medical and health service managers, administrative services managers, and office supervisors. Here experience plays a major role in hiring a person.”
Medical administrative service managers typically work a standard 40 hour week. According to the Bureau of Labour Statistics, administrative services managers perform a broad range of duties and are an important sector of the medical industry.
“Today all of our operations are dependent on payments made by our patients. Medical services in Georgia are being transited to market economy, but the legislative base still needs changes. One of the most important issues is the rights of doctors, which need to be defended. Another problematic issue in Georgia is the development of medical insurance. When an employer insures an employee there should be some additional motivators. One of these motivators could be reductions in tax payments for companies,” explained Davitashvili.
“What’s more companies should acknowledge the risks connected with insuring their employees. The contract between the firm and employee should entail that the company takes responsibility for insuring the person. The terms and conditions of insurance should also be clear,” he added.
UCC is buying equipment from Germany and Japan, from such companies as Philips and Toshiba.
“Current actions of the Government are helpful for developing medical services in Georgia. I agree that we need to bring more and more of the private sector into the medical sphere. The Government shouldn’t take part in the management of this sector.
The rising prices of medical services are problematic for many countries, not only Georgia. In the U.S. and Europe healthcare is getting more and more expensive. Countries handle this problem by increasing the budgets for healthcare.
Medical managers have to be able to make informed judgments about a range of issues and be able to give advice to senior managers and boards which is both credible and carefully prepared.