Poor Working Relationship between Doctors and Hospital Managers: A Systematic Review

BackgroundThe problem of poor relationships between doctors and hospital managers is a common feature of many healthcare systems worldwide, including the United Kingdoms NHS. Despite the significant impact that a poor working relationship between doctors and managers could have on the quality of care, there is limited research in this area. ObjectivesTo investigate the organisational factors, contributing to the poor working relationship between doctors and hospital managers with a view to recommend potential solutions to address them. MethodsWe performed a systematic literature review; a comprehensive search of AMED, MEDLINE, CINAHL, plus with Full Text, SportDiscus and EBSCO EBooks from January 2000 to July 2019 and updated in March 2022, and no further article was found that meets the selection criteria. Mixed methods, qualitative studies and quantitative studies published in English language in peer reviewed journals between January 2000 and March 2022 were included. Study selection, data extraction and appraisal of study were undertaken by the authors. Quality criteria were selected from CASP Checklist. ResultsA total of 49,340 citations were retrieved and screened for eligibility, 41 articles were assessed as full text and 15 met the inclusion criteria. These include 2 mixed method studies, 8 qualitative studies, and 5 quantitative studies. A thematic analysis was undertaken, and narrative summaries used to synthesise the findings. ConclusionThe findings of this systematic review show strong evidence of poor collaboration and lack of effective communication that contribute to poor working relationships between physicians and hospital administrators. The results from this review may guide the development of a hospital plan that involves both doctors and managers in the decision making process regarding the quality of patient care, which could potentially enhance the relationship between the two groups as it would build trust between them. O_TEXTBOXWhat is already known on this topicO_LIThe problem of poor relationships between doctors and hospital managers is a common feature of many healthcare systems worldwide. C_LIO_LIDespite the significant impact this poor relationship could have on the quality of care and patient satisfaction, there is limited research in this area. C_LI What This Study AddsO_LIWe conducted a systematic review on the effect of tension between doctors and hospital managers on the quality of care provided in hospital or healthcare centres; 15 (qualitative, quantitative and mixed) primary papers were reviewed. This qualitative systematic study found considerable evidence of organisational factors that contributes to poor working relationships between doctors and managers. C_LI C_TEXTBOX