The Health bulletin [serial] - University of North Carolina at Chapel Hill

Bl IPUBLI5AED 5YTAE N°ftTA CAROLINA STATE 5°ARD*AEALfA] BVol. 70 MARCH, 1955 No. 3J. W. R. NORTON, M.D., M.P.H., State Health Officer JOHN H. HAMILTON, M.D., EditorEFFICIENT MANAGEMENT INBy C. L. GUYTON, M.D., M.P.H.Assistant StateHealth OfficerColumbia, South CarolinaPUBLIC HEALTHEfficient means highly capable orproductive. Management means judicioususe of means to accomplish an end."Efficient Management In PublicHealth" means the judicious use of allavailable means and resources in theart and science of preventing disease,prolonging life and promoting physicaland mental efficiency through organizedcommunity effort. Since this is acontinuous process difficult of final accomplishment,the chief function orpurpose of management becomes one ofimproving and increasing the servicesrendered by wise and stimulating guidanceof the staff and coordination of allhealth activities.Efficient Management in Overall Administration.In this day when there isa tendency for governmental budgetboards, county delegations or commissionsand taxpayers to look intently atoverhead expenses of all agencies, someState Boards of Health seem inclinedto dispense with State and Districtsupervisory personnel and assign themas field workers, and some departmentsare discussing the idea of replacingregistered nurses with licensed practi-Paper Delivered at 1954 Annual MeetingNorth Carolina Public Health AssociationSeptember 23, 1954, Raleigh, North Carolina.cal nurses, replacing sanitarians with"inspectors" and replacing health officerswith lay administrators. It behoovesthose of us who have observedthese tendencies over the past severalyears to take stock and determine whythis has occurred. Is it because of a realshortage of personnel and the fact thatindividual staff members are bettertrained and, therefore, need less supervisionand management, or is it becauseour management is so indifferent andinefficient that those in control of themoney feel that it can be more effectivelyused by employing a larger staffof lesser trained and qualified personnelat lower salaries? If the healthofficer is concerned only with the medicalaspect of his job and pays littleattention to efficient management ofhis staff and program, then the questionmay well arise: Should not his fulltime be spent as a clinician and he bereplaced with a qualified lay administrator?However, I think that thisshould not apply to supervisory personneland staff workers in every unit. Inthe small and medium-sized healthunit of six to eight employees, weshould strive to have every member ofthe staff well educated and trained soas to require a minimum of supervision.Little economy can be effected by theuse of less-trained and less-qualified