Key points

• Management and leadership are separate theoretical domains butare often conflated

• The delivery of improved population health outcomes requirespractitioners to develop and use management and leadershipskills

• Different styles of leadership and management are appropriate todifferent circumstances

• Effective health professionals understand that their services areconstantly evolving and need to be able to manage change

The nature of management

Management in health-care – like medicine – is about gettingthings done to improve the care of patients. Most front-line practitionerswork closely alongside managers, but often do not fully understand whatmanagers actually do, and do not see them as partners in improving patientcare. This lack of understanding is one source of the tensions that canarise between doctors and managers.

Classical management theories evolved out of military theory and weredeveloped as advanced societies industrialised. While they recognised theneed to harmonise human aspects of the organisation, problems wereessentially seen as technical. Early theories made individuals fit therequirements of the organisation. Later theories, borrowing on behaviouralpsychology and sociology, suggest ways in which the organisation needs tofit the requirements of individuals. New management theories tend to layernew (and sometimes contradictory) concepts and ideas on top of oldercounterparts rather than replace them. A summary of the main schools ofmanagement theory is included in the Internet Companion.