Key points

• Management and leadership are separate theoretical domains but are often conflated

• The delivery of improved population health outcomes requires practitioners to develop and use management and leadership skills

• Different styles of leadership and management are appropriate to different circumstances

• Effective health professionals understand that their services are constantly evolving and need to be able to manage change

The nature of management

Management in health-care – like medicine – is about getting things done to improve the care of patients. Most front-line practitioners work closely alongside managers, but often do not fully understand what managers actually do, and do not see them as partners in improving patient care. This lack of understanding is one source of the tensions that can arise between doctors and managers.

Classical management theories evolved out of military theory and were developed as advanced societies industrialised. While they recognised the need to harmonise human aspects of the organisation, problems were essentially seen as technical. Early theories made individuals fit the requirements of the organisation. Later theories, borrowing on behavioural psychology and sociology, suggest ways in which the organisation needs to fit the requirements of individuals. New management theories tend to layer new (and sometimes contradictory) concepts and ideas on top of older counterparts rather than replace them. A summary of the main schools of management theory is included in the Internet Companion.