Health services administrators oversee the general operation of health-care
centers, and ensure that patients receive adequate care.
Health services administrators may work in hospitals, nursing homes, home
health agencies or medical units in prisons.
They may also work at special clinics and public health agencies.
Barbara Wiktorowicz, for example, is the executive director of the Women's
Health Clinic. "We're interested in women's health. That's what the clinic
stands for," she says.
Health services administration may be one of the most stressful jobs around.
These top executives work long hours managing budgets and employees. Stress
levels vary, depending on the size of the institution. But those who can handle
the pressure of the largest facilities can command large salaries and report
genuine job satisfaction.
The health-care industry is renowned for its lack of funding. According
to Wiktorowicz, a lot of an administrator's stress comes from funding issues.
"It's high stress because there's so many pressures in health....I think
most service agencies would tell you that the demands out there are always
greater than what you can meet. We're turning a lot of women away. With two
physicians, we can't serve all the women," she says.
A health services administrator is in charge of setting policies and managing
a health-care system. They oversee services, programs, facilities, staff concerns
and relations with other organizations.
Health care is big business, and the people who run health facilities often
have titles adopted from big business. Hospital administrators may be called
chief executive officers, chief operating officers, presidents, vice-presidents
and directors. The title depends on the facility.
Just as in business, these executives are responsible to boards of directors,
which are made up of either real or figurative shareholders or stakeholders.
Behind the scenes, administrators work hard to keep their facilities operating
smoothly and efficiently. That means keeping in touch with everything that
is going on at the health-care center. Health services administrators have
frequent meetings with department heads, physicians, boards of directors and
other groups that keep a facility running from day to day.
Depending on who's at the meeting, the discussions can cover everything
from long-term budget plans for the hospital to how to deal with a shortage
of kitchen staff.
In addition to meeting with people, administrators have to prepare and
evaluate proposals and communications. These reports can include personnel
evaluations, budget forecasts, recommendations and general correspondence.
Because they are responsible for what happens in their facility, it is
important that they continually meet with the employees. In general, a hospital
administrator works with a governing board and helps formulate general policies.
They then direct assistant administrators or department heads on how to carry
out the policies.
In contrast, nursing home administrators are involved in detailed management
decisions. Long-term residency and smaller facilities allow the nursing home
administrator to have some direct contact with patients.
Hours can be long in this line of work. Although they may have regular
office hours, administrators often spend evenings or weekends completing reports
or attending meetings. Many health facilities operate around the clock, so
administrators must be ready to respond to an emergency at any hour.
Most of a health administrator's work occurs at a desk, so it isn't physically
demanding. However, they certainly move around to attend meetings or visit
"You have to be a person that can juggle a lot of different things," says
Wiktorowicz. "And it's people. It's dealing with people and their lives."
In the U.S., health maintenance organizations (HMOs) are rapidly changing
the health-care scene. Some people believe HMO regulations and payment policies
encourage layoffs and substandard care -- others believe HMOs are needed to
contain rising costs. Health services managers must balance patient and budgetary
needs in this rapidly changing workplace.
Winsor Schmidt is the director of the graduate program in health policy
and administration at Washington State University. "HMOs are part of the managed
care paradigm," he says. "What it means is a significant proportion of the
health-care budget is being spent on management and administration, both in
the system at large and in individual hospitals."