Preparing Managerial Personnel for Medical Establishments at National Research Tomsk State University
The Center of Medical Management, opened at Tomsk State University in the year 2000, is realizing project of innovative research and educational for inter-university integration of knowledge in the sphere of economics, medicine and law at the university level. The project aims to provide programs for continuing professional development and upgrading skills of medical personnel from among practicing doctors, medical interns, residents, pharmacists, nurses, and senior students as well as all those wishing to gain knowledge in the field of medical management. In essence, this is training of a first generation of managers and specialists for healthcare organizations capable of effectively using the latest business technology in their professional activity. Medical management is an important area in social management, oriented at people’s health and the preservation of his ability to work and enjoy a long life – essentially, the study of organizing and managing healthcare in conditions of state and insurance financing.
Keywords: Medical managementmedical and economic clustersystematic and comprehensive trainingactive learning methodsoriginal educational programsresearch work
The market economy makes high demands of professional knowledge, ability and competence of personnel. Due to this, there is a greater role and significance of courses devoted to continuing professional development and upgrading skills. They are less costly in terms of both money and time, yet they provide for a more flexible and dynamic response to the demands of the time, enabling the training of personnel who are in-demand in the employment market.
Confirmation of the aforementioned is provided by the experience of the Center of Medical Management opened in the Higher School of Business at Tomsk State University in 2000. Its founders are M.E. Dobrusina, associate professor at TSU’s Faculty of Economics, and G.E. Sokolovich, professor at the SSMU’s Faculty of General Medicine.
It is known that market entry affects all spheres of the economy and healthcare is no exception, yet it turned out to be least ready of all for such conditions. It was thus the Center’s calling to fill in the gaps in medical personnel’s knowledge of economics, management, marketing, business planning, accounting, taxation and law.
A medical university, in our opinion, may be justly considered in the narrow and wide meaning of this word.
In the narrow understanding it is necessary to speak about professional management, i.e. lines of professional behavior by medical personnel, in particular doctors, and strategies of treatment oriented at a result. From this point of view, all doctors, having received a good education, are guided by such principles in their work. A criterion for the evaluation of their activity is quality of medical service and the final results of treatment.
In this connection we would like to draw the reader’s attention of the position of the hereditary doctor who worked for a long time abroad, A.L. Myasnikov (2013). He writes: “I came from a world where there were no standards, where medicine was art. But in the West, it’s an exact science which must be followed absolutely. Medicine is medicine. But it can be good or bad. Overseas, treatment takes place according to accepted standards. This doesn’t mean that everything is the same. It just means that a doctor’s activity there is strictly reglamented.”
Medical management – in the wide sense – is an important area in social management, oriented at people’s health and the preservation of his ability to work and enjoy a long life. It is, essentially, the study of organizing and managing healthcare in conditions of state and insurance financing.
The Center of Medical Management
The Center of Medical Management is realizing an innovative research and educational project for inter-university integration of knowledge in the sphere of economics, medicine and law at the university level. The project aims to provide programs for continuing professional development and upgrading skills for medical personnel from among practicing doctors, medical interns, residents, pharmacists, nurse practitioners and nurses in the sphere of medical management. In essence, this is training of a first generation of managers and specialists for healthcare organizations capable of effectively using the latest business technology in their professional activity.
During the foundation and development of the Center of Medical Management, it is possible to identify the following periods:
1998-1999 – the first (pilot) intake of learners for the program ‘Medical management’. 182 hours of training ending with a certificate from TSU’s Higher School of Business.
2000 – opening of the Center of Medical Management as a Faculty of TSU’s Higher School of Business.
2001-2002 – the second intake of learners. 250 hours of training ending with a state certificate on continuing professional development.
2002-2003 – the third intake of learners. 550 hours of training ending with the defense of a thesis and a state diploma on professional retraining.
2004-2012 – from the fourth to the eighth intakes and graduations of learners for the program of professional retraining ‘Economics, organization and management of medical establishments’. 800 hours of learning with a state diploma.
2012-2013 – the ninth intake and graduation of learners, with 800 hours of training. The curriculum includes five modules, ending with a TSU diploma on professional retraining in ‘Economics, organization and management of medical establishments’.
Publication of the book ‘Study support for the program of professional retraining “Economics, organization and management of medical establishments”. (Dobrusina et al., 2011).
2013 – Preparations for realizing a short program ‘Organization of healthcare and expert evaluation of incapacity to work’.
June, 2014 – Intake of learners for the programs.
The activity of the Center is based on the following main principles (Dobrusina & Sokolovich, 2002, 2006):
Amending educational programs in accordance with the learners and their educational requirements;
Systematic and comprehensive learning;
Flexibility and responsiveness;
Orienting learners to solving practical healthcare tasks based on academic research;
Engaging professors and associate professors in the educational process from seven faculties of TSU, three faculties of SSMU, the E.D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, and managers and specialists from practical healthcare and health insurance.
The educational process at the Center is carried out:
according to an original curriculum and original educational programs;
using TSU classrooms, including computer rooms;
holding practical classes on organizing healthcare at medical establishments in Tomsk;
engagement in the educational process of Center graduates, and managers and specialists in practical healthcare.
The educational programs are developed by the teaching staff of the Center of Medical Management who are its most important reserve. The vast majority of them have been working at the Center since its foundation in 2000.
The overall workload of the CPD program Economics, Organization and Management of Medical Establishments is 800 hours (Dobrusina, 2007). At the end of the program, in the organ hall of National Research Tomsk State University with the anthem of the Center ‘Remember the legacy of Hippocrates’ playing, the graduates are presented with their diplomas on professional retraining.
The curriculum includes five modules:
Basics of management for healthcare (Dobrusina & Khristenko, 2011).
Basics of law as applied to healthcare.
Restructuring of healthcare (Dobrusina et al., 2011)
Accounting and taxation.
Basics of financial management in healthcare.
The number of disciplines included in each module and the number hours allocated to each of them are constantly added to and reviewed. This is dictated by the developments in the economy and management, perfecting of the educational process, and also the learners’ educational interests.
For strengthening the organizational module in the teaching of the Center’s learners, an additional 150-hour program was developed in 2013: Organization of Healthcare and Disability Examination.
It includes the following main disciplines:
Organization of healthcare in modern conditions.
Forms and methods of medical treatment based at the Tomsk Scientific Research Institute of Spa Medicine and Physiotherapy, Federal Medical and Biological Agency of Russia.
Licensing of medical activity and quality control for medical assistance.
Organization of expert evaluation for incapacity to work.
Organization and management of state sanitary and epidemiological oversight.
Psychology of business communication in the structure of medical management (training sessions).
Complex economic analysis of medical establishments’ activity.
The content of the program is based on modern theories of management and marketing, taking into account the specifics of healthcare as a main part of the social sphere (Suslov et al., 2014). A compulsory component of the educational process is the use of active methods of learning (business games, case studies, presentations) and holding roundtables on important topical issues of medical management.
The roundtable is an integral part of the educational process for each intake of learners and has become a Center tradition. Not only are all learners invited, but also graduates of the Center. Topics for discussion included:
organization of fee-based medical services;
legal aspects of medical services provision;
marketing and examination of medicinal drugs, medical technology and healthcare items;
ethical aspects of state and private healthcare.
On 15 May 2013 a roundtable was held, dedicated to the 135th anniversary of National Research Tomsk State University, on Prospects for Various Forms of Medical Organizations in the System of Compulsory Health Insurance. The roundtable saw presentations by:
Mikhail A. Lukashov, chairman of the Council of Head Doctors at Tomsk Regions’ Department of Healthcare. Topic: Forms and Methods of Work of Healthcare Facilities in the System of Compulsory Health Insurance.
Mikhail F. Chinyaev, head of Tomsk Division of the Federal Service of Russia for the Oversight of Public Health and Social Development. Topic: State Control of Quality and Safety in Medical Activity.
Nikolai V. Rodionov, head doctor of an Emergency Medical Station. Topic: The Work of an Emergency Medical Station in the System of Compulsory Health Insurance: Initial Results and Prospects.
Natalia N. Nikolaeva, PhD, general director, Madez, Tomsk. Topic: The Activity of a Private Medical Clinic in the System of Compulsory Health Insurance.
The discussion saw participation by Prof. V.F. Baytinger, president of the Research Institute of Microsurgery at the Siberian branch of the Russian Academy of Sciences and chairman of the Center’s state examination commission; A.B. Konovalov, head doctor of the Tomsk Research Institute of Spa Medicine and Physiotherapy; and V.A. Yudin, head doctor of the TSU Health Center.
The Center of Medical Management has graduated 10 groups from the course Economics, Organization and Management of Medical Establishments. Over 130 learners have taken the course, including 40 managers from medical establishments, 15 PhDs, and one doctor of medical sciences.
Monitoring of the Center’s graduates’ professional development confirms their active progression on the career ladder in the healthcare system. In their suggested ‘Graduates’ questionnaire’ (see the appendix), they note in particular that learning at the Center of Medical Management gave them new knowledge and the opportunity of gaining interesting employment, widened their professional outlook, and considerably raised their self-esteem.
The Center pays serious attention to research work. In particular, M.E. Dobrusina made a presentation on the work of the Center of Medical Management and its prospects at an academic and practical conference held 20-21 September 2012, dedicated to the 90th anniversary of the Tomsk Research Institute of Spa Medicine and Physiotherapy, titled Modern Technology of Spa Medicine and Medical Rehabilitation.
An idea to create a medical and economic cluster at TSU is currently being discussed. This will be aided by contracts on strategic partnership concluded 16 October 2014 between:
National Research Tomsk State University, represented by its rector, E.V. Galazhinskiy, and the Research Institute of Microsurgery of the Siberian branch of the Russian Academy of Sciences, represented by its president V.F. Baytinger.
National Research Tomsk State University, represented by its rector, E.V. Galazhinskiy, and the Tomsk Regional Clinical Hospital, represented by its head doctor, M.A. Lukashov.
In September 2015 National Research Tomsk State University will host an international academic conference dedicated to the memory of the great academic I.D. Kirpatovskiy. It is of a multidisciplinary nature and the Center of Medical Management will play an active role.
Consequently, in accordance with the aforementioned, it is possible to conclude that the Center of Medical Management plays an important role in the research and educational process at National Research Tomsk State University.
Center of Medical Management, TSU, Graduates’ Questionnaire
Dear graduate, in order to improve the organization of the Center of Medical Management’s activity, please answer the following questions:
Why did you enroll at TSU’s Center of Medical Management?
Did you gain the professional knowledge required for your work?
Your own answer
Were you satisfied by the sequence in studying educational disciplines?
Your own answer
It is necessary to increase the number of disciplines studied?
Your own answer
Is it necessary to increase the number of hours spent on any of the disciplines?
Your own answer
Were you satisfied with the study support provided for the disciplines (guides, textbooks, handouts, electronic resources, etc.)?
Your own answer
Did you have any difficulties in writing your thesis?
Difficult to say
Your suggestions for improving the educational process at the Center of Medical Management:
- Dobrusina, M.E. and al. (2011). Educational support for a continuing professional development program in Economics. Organization and Management of Medical Establishments. Tomsk. Tomsk State University, 444 p.
- Dobrusina, M.E. Sokolovich, G.E. (2002). Educating medics in medical management at Tomsk university – a foundation for innovative activity. Proceedings of the All-Russian conference ‘The innovation business of Russia: prospects for the development and training of personnel – the example of the Association of Siberian and Far East Towns’. 16 – 21.
- Dobrusina, M.E. (2007). A successful example of postgraduate teaching. Man and Work, 7, 76 – 77.
- Dobrusina, M.E., Khristenko, K.Yu. (2011). Organization of Work and Chronic Fatigue Syndrome. Journal of Tomsk State University, 345, 143 – 148.
- Dobrusina, M.E., Sokolovich, G.E. (2006). The Center of Medical Management at Tomsk State University – inter-university integration of knowledge. Journal of Tomsk State University, 292, 319 – 321.
- Dobrusina, M.E., Zavyalova, G.N., Tulupova, O.N., Khlypin, S.M. (2011). Public-private partnership as an innovate form of developing Russian healthcare. Ekonomika, 1 (13), 142 – 147.
- Myasnikov, A.L. (2013). How to live 50 years longer: an honest conversation with a doctor about medicines and medicine. М.: EKSMO, 192.
- Suslov, N.I., Churin, A.A. Dobrusina, M.E., Losev, E.A. (2014). Pharmaceutical Marketing: A Textbook. Tomsk.Tomsk Polytechnic University Press, 320 p.
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17 January 2017
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Dobrusina, . (2017). Preparing Managerial Personnel for Medical Establishments at National Research Tomsk State University. In F. Casati, G. А. Barysheva, & W. Krieger (Eds.), Lifelong Wellbeing in the World - WELLSO 2016, vol 19. European Proceedings of Social and Behavioural Sciences (pp. 152-158). Future Academy. https://doi.org/10.15405/epsbs.2017.01.20