The impact of the new hospital concept on the doctor's education: the place for physician-executives.

Health care cost containment and the involvement of physicians in the hospital management are features spreading throughout the Western nations. In fact, physician-executives are needed to preserve an optimal level of care while achieving the aims of the cost containment policies. Belgium is no exception: the new hospital law outlines the physician's status in relation to the hospital management and provides for the implementation of a prospective payment system. An important point is examined in this paper: the problem of the physician's management skills. In order to solve this problem, two methods were used to collect data. First, an analysis of the tasks provided in the law and its commentary was helpful to determine the main skills needed if physicians want to act as hospital managers. Second, market research in management education was carried out to discern the number and the characteristics of physicians who could be interested in receiving management training. A physician-dedicated curriculum was developed from the first approach. The second approach revealed that half the hospital doctors are willing to train as managers, providing they are actually involved in hospital management. Therefore, universities and their Schools of Medicine should develop such curricula. Nonetheless, studies should be conducted to clarify the relationship between physician-executives and other physicians and to assess the impact of the presence of physician-executives on the hospital organization and on the quality of care.