Good clinicians can marry managerial skills with clinical qualities. They must have a realistic appreciation of the management component and positive attitudes towards it. There is no doubt that, although different, clinical training and management training can enhance some of these skills. The aim of training must be to increase awareness of the qualities required for management so that the service can be improved by regularly reviewing clinical practice and evaluating different components of service. Managers must foresee and attempt to eliminate barriers between different professions. They must also have the skills and ability to say no.
As discussed above, the management process includes management of resources—both financial and human—and, at a more personal level, time management, negotiation, committee management, etc. By virtue of their professional training, psychiatrists will already have the skills for negotiation and committee management, but they may need to learn other techniques and such learning can take different forms.
Management courses are one option, but significantly more can be learned by shadowing senior clinician or non-clinician managers and through practical experience. This involves management at a fairly junior level such as being involved in committee work, working parties etc. The senior clinician in private settings or in non-teaching settings in some countries may not take on these responsibilities and may not have the opportunity of doing so. The clinician manager may take the lead in establishing training programmes for nurses, psychologists, social workers, and occupational therapists as required.
Although continuing professional development has been established for some time with increased emphasis on revalidation and accreditation, the clinician has to set time aside to manage personal growth. Managers have to learn to manage emotions as well as workplace pressure in order to be able to delegate nd communicate. Good verbal communication is a two-way process and, in view of their training, psychiatrists ought to be good at it. The process of communicating with people is well described by Humphries.'4) The right language, the right tone, and appropriate non-verbal communication are all important facets of good quality communication.
The medical profession continues to insist that it controls its own standards—a tradition long enjoyed and generally accepted, although pressure is increasing to change this and to make a distinction between management and clinical practice.
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