[oldalum]

But this is a guy who spent the first 30 years of his career training as a doctor and being a doctor.  Why did they let someone with no management experience run a medical center? . . . What do they know about really running anything?  How does all of that time they spent getting a phd or becoming a doctor help them run a large organization?

Just a guess (I know nothing about RR except that he was once one of ours), but it could be because he had intimate knowledge of and first-hand experience in producing the core "output" of a medical center (patient care and knowledge) (i.e., he had in-depth knowledge of the "business"), had a vision of what that medical center could be and do that was appealing to the Board that hired him, and a plan for how to get there. And at least in theory he could inherit or hire people who could fill in his gaps in knowing how to "run" a medical center. But assuming RR was either a bad hire or is doing a bad job, or both, I would question extrapolating his individual performance to the other "doctors" who are running almost all (if not all) of the many medical centers around the U.S. Is there evidence that collectively they are really doing a bad job?

Typically, doctors who have leading administrative roles are not simply plucked from the ranks of those just "being a doctor;" they start with lesser administrative roles (department chair, head of an institute, associate dean of a medical school) and have the interest and talent to take on bigger roles. Doesn't mean they don't have holes in their preparation for and experience in leadership roles. But the alternative of having non-physicians in charge of medical organizations is not a panacea, either: within medicine there is, to put it mildly, extreme discontent with many MBAs who are now in charge of medical organizations or parts thereof. How medical organizations are run affects the quality of patient care they provide, in ways that non-physicians may not understand or care about. There are growing numbers of MD-MBAs but I am not familiar with the experiences with them, except for a close friend who practiced medicine, started assuming some administrative roles, got an MBA along the way, and kept getting promoted until now she's head of a major medical foundation.

Putting a physician in charge of a university is a different matter, but the seemingly universal practice of tapping professors to be presidents poses analogous issues to having doctors run medical centers.

[oldalum]

But this is a guy who spent the first 30 years of his career training as a doctor and being a doctor.  Why did they let someone with no management experience run a medical center? . . . What do they know about really running anything?  How does all of that time they spent getting a phd or becoming a doctor help them run a large organization?

Just a guess (I know nothing about RR except that he was once one of ours), but it could be because he had intimate knowledge of and first-hand experience in producing the core "output" of a medical center (patient care and knowledge) (i.e., he had in-depth knowledge of the "business"), had a vision of what that medical center could be and do that was appealing to the Board that hired him, and a plan for how to get there. And at least in theory he could inherit or hire people who could fill in his gaps in knowing how to "run" a medical center. But assuming RR was either a bad hire or is doing a bad job, or both, I would question extrapolating his individual performance to the other "doctors" who are running almost all (if not all) of the many medical centers around the U.S. Is there evidence that collectively they are really doing a bad job?

Typically, doctors who have leading administrative roles are not simply plucked from the ranks of those just "being a doctor;" they start with lesser administrative roles (department chair, head of an institute, associate dean of a medical school) and have the interest and talent to take on bigger roles. Doesn't mean they don't have holes in their preparation for and experience in leadership roles. But the alternative of having non-physicians in charge of medical organizations is not a panacea, either: within medicine there is, to put it mildly, extreme discontent with many MBAs who are now in charge of medical organizations or parts thereof. How medical organizations are run affects the quality of patient care they provide, in ways that non-physicians may not understand or care about. There are growing numbers of MD-MBAs but I am not familiar with the experiences with them, except for a close friend who practiced medicine, started assuming some administrative roles, got an MBA along the way, and kept getting promoted until now she's head of a major medical foundation.

Putting a physician in charge of a university is a different matter, but the seemingly universal practice of tapping professors to be presidents poses analogous issues to having doctors run medical centers.