Doctors managing in primary care: An international focus

Abstract As well as looking after their patients and running their own small businesses, family doctors have to build and sustain an increasingly complex web of long-term relationships. These doctors require an independent entrepreneurial spirit as well as an ability to influence others without having direct authority over them. They also need to be politically astute, to understand 'the big picture' of how health services function as a whole, but also be able to work through the detail to ensure seamless patient care. Finally, given the nature of primary care, and its place in healthcare systems, this paper concludes that those doctors who are by nature problem-solvers, tolerant of ambiguity and inherent optimists are those who thrive best in this particular management environment. The paper draws its arguments from the organisational context of health services and the position of primary care doctors within that system. It examines the future in terms of emerging health service trends and wider societal pressures. This leads to an analysis of the key management competences. What does it take to manage as a doctor in primary care and how can doctors prepare themselves for this role?