Article Text

Download PDFPDF
Doctors and managers: poor relationships may be damaging patients—what can be done?
  1. N Edwards
  1. NHS Confederation, 1 Warwick Row, London, SW1E 5ER, UK
  1. Correspondence to:
 Mr N Edwards
 NHS Confederation, 1 Warwick Row, London SW1E 5ER, UK;


The problem of poor relationships between doctors and managers is a common feature of many healthcare systems. This problem needs to be explicitly addressed and there are a number of positive steps that could be taken. Firstly, there would be value in working to improve the quality of relationships and better mutual understanding of the necessarily different positions of doctors and managers. Finding a common approach to managing resources, accountability, autonomy, and the creation of more systematic ways of working seems to be important. The use of costed clinical pathways may be one approach. Rather than seeing guidelines and accountability systems as a threat to autonomy there is an argument that they are an essential adjunct to it. Redefining autonomy in order to preserve it and to ensure that it encompasses accountability and responsibility will be an important step. A key step is the development of clinical leadership.

  • poor relationships
  • clinical leadership

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles