Prof. Dr.

Didik Tamtomo , dr,PAK, MM,Mkes, SpDLP

What is Management?
The art of getting things done through people
Mary Follett (1868-1933)

Management is archievement of organisational goals

through the major functios of planning, organising,
leading and controlling
 Planning
◦ Defining goals, establishing strategy , and
developing plants to coordinate activities.
◦ Long term planning called strategy. Short term
planning called operational
 Organizing
◦ Determining what tasks to be done,
who is to do them, how the task are to be
grouped,who reports to whom,
and where decisions are to be made
 Leading
◦ Motivating employees, directing the activity of
others, selecting the most effective communication
channel, and resolving conflicts
 Controlling
◦ The process of monitoring
performance comparing it with
goals, and connecting any
significant deviations
 An extended model of management process

Knowledge Base &

Key Management
Manageme Skills
n
Functions:
•Planning
•Organising
Work Performance
Work •Leading
Methods& (goal
Agenda •Controlling
Roles Achievement)
 ◦Money
◦Manpower
◦Material
◦Methods
◦ Machine
 Interpersonal  Decisional
◦ Figurehead ◦ Entrepreneur
◦ Leader ◦ Disturbance hander
◦ Liaison ◦ Resource allocator
 Informational ◦ Negotiator
◦ Monitor
◦ Disseminator
◦ Spokesperson

Mintzberg
Ceremonial and symbolic
 Figureheads: obliged to perform a number of
routine duties of legal or social nature. Ex.
Greeting visitors
 Leader role: responsible for hiring, training,
motivating and disciplining employees
 Liaison role: developing channels of
communication, especially informal channels with
other coorporate directors, political connections,
media public figure.
 Receiving, collecting and disseminating information
 Monitor: selecting information , meetings, memos,
social fuctions,mail,public gatherings
 Disseminator: Passing relevant information to
subordinates
 Spokerperson: Transmit information to outsiders
 Making decisions
 Entrepreneur: identify opportunities and threats,
initiates improvement change
 Disturbance handler: corrective action unexpected
disturbances
 Resource allocator: allocation resources (ex:
budgeting)
 Negotiator: responsible at major negotiations
(contract negotiating)
◦ Technical skills: knowledge of and proficiency in a
specialised field
◦ Human relation skills: the ability to work with other
people individually and in a group
◦ Conceptual skills: the ability to think and to
conceptualise about abstract and complex situation
 Managerial competencies are the knowledge,
skills, behaviours and attitudes that a
manager needs to be effective and efficient
 Effectiveness
◦ An ability to choose and achieve appropriate goals
 Efficiency
◦ An ability to make the best use of resources in
achieving goals

Drucker
 Scope of People Management

◦ Recruitment • Motivation
◦ Selection • People Handling
◦ Induction Training • Structures
• Leadership
• Personal
effectiveness

◦ Staff
development
◦ Separation
◦ Promotion
 An important role of a manager is to motivate
the people working on a project.
 Motivation is a complex issue but it appears
that their are different types of motivation
based on:
◦ Basic needs (e.g. food, sleep, etc.);
◦ Personal needs (e.g. respect, self-esteem);
◦ Social needs (e.g. to be accepted as part of a
group).
 Grievances
◦ External Circumtances
 poor working conditions
Solution: improving working condition
◦ Internal Circumtances
 staff disstress cause bad personal relationship
Solution: counseling , transfer to a different job,
or different departmen.
 Discrepancies
◦ The discrepancies
 Cash.
 Medicine
 Medical supplies

◦ Solution
 Investigation
 Identify person
 Paying back
 Absenteeism
◦ poor physical condition,boredom,inadequate
supervision, stressful environtment,
inconvenient working hour, individual of health,
distance from work, family responsibilities
◦ Solution:
regular job rotation, employee participation in
decission making, Improve rekruitmen in selection
procedure, bonus, counseling
 Defined as planning in the future
 Basic of strategic planning
◦ Identification of current objectives and strategy
◦ Analysis ot the external environment
◦ Analyis of the organization’s strenght and
weaknesses
◦ Strategic dicision making
◦ Strategic implementation
 Non Price competition
◦ Modern
◦ Elegant facilities
◦ Increase accessibility and acceptability
◦ Developing image
 Vertical integration
◦ Entering service paticipating
Ex: pharmaceutical facility, labolatory
 Foward integration:preventif
 Entering service to end user
 One stop service
 Health related clinic
 Horizontal integration
◦ Entering into arrangements to link service outlet to
achieve economic of scale or more efficient
management of capital resource
Purpose:
 Communication
 Basis for communication between health proffesionals.
 Informs the treatment and care planned
 Outcame of that care as a continuos
 Accountability
 Clinician accountability and proffesional practice
 Legislative requirement
 Identify and required spesific information
 Quality improvement
 Evaluate proffesional practise as a part of quality insurance
 performance review
 audit and acreditation
 Critical insident review
 Implement change base
 Research
 Source of data for head researcher
 Funding and research managemen
 Tool for identifiying the type of care that patiens require
 Efficiency and effectiveness of care service
 Benefit:
◦ Easy to identifying parctice patterns
◦ Locating innefficiecies in patien care
◦ Assining probabilities to diagnosis
◦ Delivering reports and consulting service rapidly
◦ Achieving from billing
 Barrier
◦ Cost
◦ Confersion of written to computerized records
◦ Confidentially and staff training
◦ Disconfort with change
◦ Lack of technical support
 Selecting the appropriate source of fund
 Raising the required funds at the right time
 Administration of earnings
 Estimating the volume of funds
 Income
◦ Source of income
 Consultation
 Sale of medicines
 Fees for service such as a vaccination
 Housecalls
 Investment from surplus revenue
 Expenses
◦ Staff cost: salaries, bonus,insurance
◦ Occupansy cost: rents rates, repairs, insurance,
telepones
◦ Drug cost: cost of drugs pharmaceuticals and
instruments
◦ Other cost :book ,journal, equipment, postage
 Profit
◦ Income – Expenses = Profit
◦ For tax purpose, only the profit is taxable

 Financial record
 A proper planning of purchasing of raw
material handling storing and recording is to
be considered by the inventory management
 Inventory control
• Guided by donatur of practice
• Habit of practicing staff
• Number of patient served
• Seasional variation and epidemic
 Stock Control
◦ Stock card
◦ Storage and shelf life (vaccines)
◦ Expiry dates – FIFO
 Managing discrepancies
◦ Definition: difference between recorded and actual
quantity (money or inventory)
◦ Reason for discrepancies
 human error
 medicine counting error
incomplete recording
 pilferage
 Fraud
 Prefentive
◦ Open system
◦ Declare disiplinary
◦ Random chec
◦ Personal accoutability
◦ Personal use for medicine to be authorized
 “Managed care” was touted as a way for
employers to “manage cost”
 Attempt to reduce cost and shift risk of
health expense from the company to the
insurer
 Company would pay set amount and insurer
would assume all risk
 Insurer would then “manage” the patient to
reduce costs
 If you keep people healthy, you reduce costs
 If you only give people what they need (as
opposed to what they want), you can reduce
costs
 If you make providers and patients aware of
costs, they will be more prudent in their use
of services
 Patients were assigned a primary care doctor
included in the plan
 Access to specialty care or hospital services
only available through PCP (or “gatekeeper”)
 Only services deemed medically necessary
covered; physicians could appeal decision,
but if not covered patient would have to pay
 Health maintenance organization (HMO):
◦ Patients had access to limited physicians and
hospitals but all costs covered
 Preferred provider organization:
◦ Patients were assigned PCP and told which hospitals
and specialists “in network”
◦ If using network doctors/facilities, costs covered
(usually with small co-payment)
◦ If using out of network, patient paid larger part of
the cost of care (20% of more)
 Capitation: pay providers set amount (like
DRGs) to take care of individual patients
 Risk-pools: take set amount of money and
put it in a pool that providers will share at
the end of the year … providing it hasn’t
been used to pay for costly services
 Hire them: HMOs formed “group models”
where the doctors worked for them and had
an incentive to keep costs low
 Incentives: some plans gave incentives,
gifts, etc., to patients to come in for
preventive services or adopt healthy
lifestyles
 Price differentials: plans offered two-tiered
pharmacy services… low co-pay for
generics, high co-pay for brand names
 Point-of-service plans: Pay less for MD that
is “in network” and more for service
provided “out of network”
“Menjadi Dokter adalah baik,
Menjadi Pedagang adalah baik,
Tetapi Menjadi dokter dan
pedagang adalah tidak baik”
 
Menjadi Dokter dan Pedagang adalah

luar biasa
yang tidak baik adalah

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