The Professional in Bureaucracy

The Professional in Bureaucracy- Physician Owned Services In order to understand what is going to be discussed we must first define bureaucracy. According to Wikipedia, bureaucracy is the combined organizational structure, procedures, protocols, and set of regulations in place to manage activity, usually in large organizations (Wikipedia 2010). Basically bureaucracy is a chain-of-command type of organization. Within this type of organization problems can arise between the physician and the organization in that the physician must also follow a chain-of-command role. We are going to look at the physician within a bureaucracy and how certain bureaucracies of Medicare and hospitals affect the physician-patient relationship. According to Max Weber there are seven characteristics of a bureaucratic organization. They are a fixed division of labor, hierarchy of offices, authority of officials, rules that control performance, workers do not own the resources to do the job, business is done with written documents, and there are clear career paths one can follow. Weber made it clear that the characteristics of the bureaucratic organization were developed to solve problems. According to Weber, these characteristics when executed effectively, would allow the organization to be highly efficient. If Weber’s type of bureaucracy is so effective then why are doctors leaving hospitals and joining other doctors to open specialty hospitals? Physicians are looking for ways to cut off the bureaucratic leadership in hopes to improve patient care and to create more time to spend with their patients. Physician owners argue that physician owned hospitals are more efficient, provide better care, and have a higher patient satisfaction then community hospitals (Bristol 2005). One of the most important parts of a physician owned hospital is that if a change needs to be made it can be made and implemented in a few days. Within a major hospital system changes would take weeks,

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