Scientific Management and Bureaucracy in Healthcare Facilities

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The theory of scientific management is also frequently referred to as Taylorism after its author, Frederick Winslow Taylor. He was among the earliest management theorists in the twentieth century when the most considerable achievements in managing work and business were made (Mind Tools Content Team). The novelty of his ideas lies in an attempt to study the work processes from the scientific viewpoint in order to discover how they could be optimized for maximal productivity.

One of Taylor’s major principles was replacing the so-called rule of thumb with the scientific method. Simply put, he insisted on rejecting the habitual traditionally used methods and applying the scientific approach to the search for the most efficient ways to complete particular tasks (Mind Tools Content Team). An illustrative example is the case of Ignaz Semmelweis, who is believed to have initiated aseptic processing. He literally taught obstetricians to clean their hands and appliances before delivering a woman. His discovery contradicted a range of doctrines that contemporary medicine had traditionally relied upon. However, its implementation enabled an immense reduction in mortality of birthing mothers and newborns at the hospital where he was working.

Taylor also insisted on an adequate task allocation instead of simply setting any piece of work to a random staff member. According to him, the most meaningful criteria for assigning a certain job are the worker’s capability and motivation (Mind Tools Content Team). Nowadays, this principle is recognized among the key ones of a successful business, and the healthcare industry is not an exception. For instance, the province of a general practitioner is dramatically limited as a serious problem with a particular organ or system requires consulting a specialist in the respective area. An approach of that kind allows a substantial increase in treatment quality simply because a single person cannot know everything needed.

Another innovation Taylor implemented was an interaction between managers and workers, who had been almost completely separated from each other before. Little to no control over the work resulted in the impossibility of both monitoring quality and protecting the workers’ rights (Mind Tools Content Team). Meanwhile, properly organized cooperation enables competent supervision and easier implementation of the most efficient decisions, methods, and techniques at all levels. A poorly coordinated action may, for example, lead to a situation where a hospital has up-to-date equipment but the person does not have the appropriate skills to work with it.

The final point to mention in the context of Taylorism can be considered a summary of the previous two. Managers and workers are to do different jobs, specifically, the former “spend their time planning and training” while the latter realize (Mind Tools Content Team). This is the reason why a head physician may not have enough time for regular medical consulting, being completely involved in administrative work. An attempt to combine the two roles will most probably compromise the quality.

The term “bureaucracy” describes a system of the administration represented as a hierarchy of officials whose duties vary from one position to another. This is not necessarily a state governmental system as long as a particular business or institution can follow the same scheme. Hospitals as well as other healthcare facilities are not an exception and frequently have at least some of the characteristics of bureaucracy.

A bureaucratic institution needs to be independent of persons, which means identical attitudes to all visitors notwithstanding their status or personal characteristics. Medical personnel, who are not allowed to reject treating or caring for a patient on their personal grounds, personify this feature. Another example is the unacceptability of performing surgery on close ones including family members, which presupposes that a doctor cannot remain impartial under circumstances of that kind.

Standardization of responsibilities is closely associated with that of tasks, which is hence a marker of bureaucracy as well. Every staff member at a healthcare facility has a specific scope of duties and no right to do anything beyond that scope. Thus, nurses are not allowed to prescribe medications or procedures even if they are well aware of how to treat a certain disease. Their job lies in assisting doctors by completing specific tasks that depend on the situation.

Overall, bureaucracy involves the delimitation of competencies, which is transparently derivable from Taylor’s scientific management theory. It is worth noting that the delimitation can be both horizontal and vertical. Various specializations of medical advisers exemplify the former as those advisers have similar positions in the hierarchy but different responsibilities. By contrast, nurses, doctors, and head physicians, who have different duties, also represent the different hierarchy levels.

The final characteristic of bureaucracy is the principle of verifiability, or, simply out, the possibility of control and examination. For instance, all of the levels mentioned in the previous paragraph are reporting to a higher one: nurses to doctors, and doctors to head physicians. Such a system allows monitoring the quality of work constantly, resulting in increased productivity in accordance with Taylor’s theory.


Mind Tools Content Team. (n.d.) Frederick Taylor and scientific management: Understanding Taylorism and early management theory. Mind Tools. Web.

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