The face of the family doctor is changing. He is not the friendly, though at times weird looking, stethoscope wielding old be-spectacled, who takes care of your troublesome tummy. He has grown out of this role. Well he has to. No, not that, he is already a philanthropist, a social scientist … but today he is a manager! Hard to believe? Believe it.

Way back in 1976, B. Longest described a paradox that was created due to advancement in technology and clinical proficiency; there was a growing dissatisfaction among the client provider system. This paradox still continues to exist. Doctors now need to cross borders; they cannot remain as just clinicians. Badly managed organizations frustrate staffs, pain the patients and spoil the practice.

Traditionally doctors are not trained in management. There may be some orientation courses here and there for leadership etc. but not management as a good portion. Management is a mammoth science in itself encompassing everything: man, money and material. Doctors despite no training do have to occupy management positions due to appointment. Except for a few, many doctors really cocooned in their disciplinary niches.

But in modern day health care systems doctors are losing out due to this lack of management skill. And many doctors in US are going back to school not to obtain another degree in Medicine but a degree in management. At least a third of US Medical colleges are offering an MD/MBA programme in association with a business school.

Do you really think that management skills are really required by our dear doctors? The Modern Health care personnel at many levels require Mangement skills. This may be a doctor's own practice clinic, a poly clinic or a big hospital setup- both private and public. Effective management in such complex Health care system requires that the doctor or even the nurse have knowledge and skills related to management, organization behaviour, communication and decision making skills and mastery of a repertoire of roles to implement new alternatives and innovation of change.

Lacking these The doctors and nurses in the managerial roles often resort to avoidance or compliance behaviour, which results in uncreative, reactive, illness-oriented care.

Are they really heading towards the right direction? Many say no and many still say yes. Those who say no argue that it conflicts with professional duties and adds unnecessary work. And those who say yes believes that multidisciplinary management education in medical school and even formal PG training like MD/MBA programme are needed to produce doctors who can contribute to management of this Organization.

Whether we like it or not this is certainly wind of change. But unfortunately many of our Institutions are headed by technical expert with a fine career and good ACR. But the roles he is expected to play are totally different from what he is experienced. Like a neurosurgeon heading an organization. Should all those in managerial roles be retrained and in what areas?

Will they be willing? These are some other questions. Let us try to answer them some other day.