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Medical Administration

Definition

Medical administration covers a variety of health care management jobs in a number of settings, from managing a clinical department to overseeing a medical practice or large hospital.

Description

Many medical personnel serve at the frontline of a health care organization by directly providing patient care. Other professionals serve in the background, ensuring that the organization has the money, equipment, and staff available every day to remain open and able operate effectively. These are the medical administrators.

Medical administrators may also be called health care managers, health care executives, medical practice administrators, hospital administrators, and a number of other terms related to their specialty or the facility in which they work. As a business, health care is one of the most complex and evolving, thus requiring highly skilled managers to keep organizations running smoothly. Medical administrators are called upon to plan, direct, and coordinate health care delivery. They may be in charge of specific departments or services, or they may manage the entire facility or a health care system.

In most instances, medical administrators supervise other workers, prepare or work with budgets, manage projects, and are called upon to improve efficiency in a complex and rapidly changing health care environment. They also must deal with evolving technological innovations, and economic and regulatory changes.

Work settings

Typical work settings and related responsibilities for many medical administration positions are listed below.

Hospital administrator

The role, training, and daily responsibilities of the hospital administrator may vary depending on the size and type of facility. In general, administrators of large hospitals oversee other managers/administrators who handle daily operational issues and report to the hospital administrator. The administrator also may be called the chief executive officer, or CEO. The CEO in turn usually reports to a board of directors and may report to or work closely with, a physician executive. Other managers reporting to the administrator/CEO may oversee clinical departments and operations or administrative functions such as finances, quality, or marketing. If the hospital belongs to a large corporation or health care system, the hospital administrator/CEO may also report to a higher executive within the organization.

The hospital administrator will handle more day-to-day operations in a smaller facility. In a smaller hospital, there may be fewer managers to help with these tasks, leaving the hospital administrator to be directly responsible for many of the financial and operational details of the facility. The reporting structure usually includes some sort of board or corporate organization, even for a non-profit community hospital. A public or academic hospital may also have an organizational structure through which the administrator may report.

Nursing home administrator

Nursing home administrators often perform duties similar to those of small facility hospital administrators. However, managing a nursing home differs in terms of regulations and daily operation. Administrators also work in hospices and home health organizations. These organizations may operate in conjunction with a nursing home or as an independent agencies. Larger agencies may need nursing managers to report to the agency's top administrator as well.

Clinical manager

Hospitals and some nursing homes, as well as other outpatient facilities and medical practices, need clinical managers to operate smoothly. Clinical managers usually have specific responsibilities for a medical area and specialized training or certification is usually needed in the specialty involved. For example, a nurse may become a unit or floor manager or a nurse administrator for the entire hospital. Another nurse may oversee infection control for the facility or system. A radiology technologist may become A department head for all medical imaging in a hospital.

Medical practice administrator

An administrator works closely with physicians to manage the physicians' group practice. In small practices, the administrator may also work an office manager, overseeing billing and accounting functions, as well as hiring and supervising staff. However, in recent years physician practices have grown larger and more complex. Many medical practice administrators have managers assisting them in these and other functions while they serve as a CEO or chief administrator, reporting to a physician board. The chief administrator may oversee practice planning, budgeting, equipment outlays, patient flow, and personnel management.

Managed care administrator

Managed care settings need health care managers to perform functions similar to managers in hospitals and group practices. For example, many managed care plans must follow quality guidelines, work closely with providers to ensure they are providing efficient care, and offer and monitor preventive care to health plan enrollees.

Other medical administrators

A shift from a focus on inpatient care to outpatient care has led to an increased number of outpatient facilities that need medical administrators. Examples include outpatient medical imaging centers and ambulatory surgery centers. Other facilities may focus on a particular medical specialty, such as cardiology care, opening positions in medical administration. For example, an experienced radiation therapist may be promoted to department manager, then become administrator of an oncology center. Public health agencies hire managers at various levels, as do academic settings. Large health care systems and corporations hire medical administrators for various roles, including the role of CEO. Some medical administrators work for health care management companies that provide management or consulting services to health care providers.

Education and training

Education and training requirements vary, depending upon the specific administrative position and work setting. Overall, any medical professional interested in an administrative career should become familiar with management principles and practices, as well as health care economics. In most cases, a minimum of a bachelor's degree will be required to manage a health care facility or medical group practice.

One may wish to obtain a bachelor of science (BS) degree in health services administration. If so, the Association of University Programs in Health Administration provides a list of undergraduate programs certified to provide health administration education. Some medical administrators enter the profession with a BS degree in business or in the medical specialty in which they practiced, such as nursing. Having a BS degree of any kind is often a prerequisite for entry-level administrator jobs or for certain licenses or certifications required to hold administrator positions. For example, most states require a BS degree to hold a nursing home administrator's license.

For a clinical manager position, advanced training or certification and experience in the specialty often is adequate, although a BS may be preferred or required. As clinical managers advance, they often will need advanced degrees in their clinical specialties, as well as a degree in health services administration or a similar discipline. The same often is true of middle management positions in hospitals, physician group practices, and other health care organizations. Managers may enter based on clinical or administrative specialty experience, licensing, or education, but may require at least a BS in health services administration or general business in order to advance further in medical administration.

Advanced education and training

Many medical administration positions require a master's degree as well. The Accrediting Commission on Education for Health Services Education provides a list of accredited graduate programs in health administration. Depending on the job and work setting, an administrator may choose to obtain a master's degree in business administration, public administration, health services management, or a health specialty. Some master's programs allow students to specialize in a specific facility type, such as hospitals, mental health facilities, or medical group practices. Graduate programs generally last two years, but may take a student longer if he or she is working full-time while studying. Typical health care management coursework includes courses in health care policy and law, marketing, organizational behavior, health care financing, human resources, and other health care management topics.

Some administrators may pursue a doctoral degree in health services administration or a related specialty. Advanced education in medical administration may also involve special certifications and fellowships from specialty organizations. For example, the American College of Healthcare Administrators offers a professional certification program for nursing home administrators. Medical group administrators may become fellows in the American College of Medical Practice Executives. The American College of Healthcare Executives also offers a fellowship program.

Future outlook

Health care organizations will always need qualified administrators to help manage clinical and business operations. Employment for medical administration jobs is expected to grow faster than the average for all occupations through 2012, according to the United States Bureau of Labor Statistics. While the majority of positions will remain in the hospital sector, the fastest growth will likely occur in outpatient settings, such as medical group practices, home health agencies, and other outpatient facilities as a trend toward outpatient care continues. Earnings vary by type of setting, geographic region, and responsibility. Overall, medical administrators earned an average of $61,000 to $125,000 in 2002.

Resources

BOOKS

"Medical and Health Services Managers." Occupational Outlook Handbook. Bureau of Labor Statistics, 2005.

ORGANIZATIONS

American College of Healthcare Administrators. 300 N. Lee St., Suite 301, Alexandria, VA 22314. (888) 882-2422. http://www.achca.org.

American College of Healthcare Executives. 1 N. Franklin St., Suite 1700, Chicago, IL 60606. (312) 424-2800. http://www.ache.org.

American College of Medical Practice Executives. 104 Inverness Terrace E., Englewood, CO 80112. (303) 799-1111. http://www.mgma.com/acmpe.

American Organization of Nurse Executives. 1 N. Franklin St., Suite 1700, Chicago, IL 60606. (312) 422-2800. http://www.aone.org.

Association of University Programs in Health Administration. 2000 N. 14th St., Suite 380, Arlington, VA 22201. (703) 894-0940. http://www.aupha.org.

Commission on Accreditation of Healthcare Management Education. 2000 14th St. N., Arlington, VA 22201. (703) 894-0960. http://www.cahmeweb.org.

Medical Group Management Association. 104 Inverness Terrace East, Englewood, CO 80112. (877) 275-6462. http://www.mgma.com.

OTHER

Career Services. American College of Healthcare Executives Website. 2005. http://www.ache.org/carsvcs/ycareer.cfm.

Getting Started. American College of Healthcare Executives Careers in Health Management Website. 2005. http://www.healthmanagementcareers.org.

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