Doctor in the process. The engagement of clinical directors in hospital management.

Aims to examine medical involvement in hospital management processes, and to consider the implications of current experience for the next generation of clinical directors. Doctors who move into a formal management role often find themselves unprepared for their new responsibilities. Research has thus concentrated on identifying the management competences which doctors lack, and with designing ways to remedy the deficit. Seeks to move beyond this deficit model by adopting a perspective which focuses on the engagement of doctors in the management process. Draws data from in-depth interviews with six clinical directors and 19 other members of the hospital management team at Leicester General Hospital NHS Trust (LGH). Content analysis of interviews suggest that the engagement of clinical directors in the hospital management process at this site can be described as reluctant, transient, service-driven, power-pulled and pressured. This negative portrayal of the role, however, must be set in the context of the "management expectation" held of clinical directors by other hospital managers and staff--an expectation that is not currently fulfilled.