在欧美的趋势是医院公司化，领导职业经理人化（没有医学相关学位的人领导）。国内离这一步还差远吧，医生联盟统治的医院几乎是滴水不漏的。现在有文章检验欧美的趋势，但是结论离因果效应还差得远吧。
Top-performing hospitals are typically ones headed by a medical doctor rather than a manager. That is the finding from a new study of what makes a good hospital.
Its conclusions run counter to a modern trend across the western world to put generally trained managers — not those with a medical degree — at the helm of hospitals. This trend has been questioned, particularly by the Darzi Report, which was commissioned by the U.K. National Health Service, but until now there has been no clear evidence.
Amanda Goodall PhD, at the Institute for the Study of Labor (IZA) in Bonn, Germany, constructed a detailed database on 300 of the most prominent hospitals in the United States. She then traced the professional background and personal history of each leader. The research focused particularly on hospital performance in the fields of cancer, digestive disorders and heart surgery.
The study shows that hospital quality scores are approximately 25% higher in physician-run hospitals than in the average hospital.
Goodall stressed that more research would be needed before cause-and-effect could be truly understood. The study, a cross-sectional one, uses data from 2009. "This is an intriguing pattern but these snap-shot results for a single point in time do not prove that doctors make the best heads of hospitals, although they are consistent with that claim. More research following a range of hospitals through time is urgently needed," she said.
"Physician-Leaders and Hospital Performance: Is There an Association?", by Amanda H. Goodall, is in press at Social Science and Medicine. It can be downloaded free of charge as from the IZA website (www.iza.org) as IZA Discussion Paper No. 5830:http://ftp.iza.org/dp5830.pdf
