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Health Care Managers

History

Health care institutions have changed considerably since the Pennsylvania Hospital was established in Philadelphia in the mid-1700s by Benjamin Franklin and Dr. Thomas Bond. The rapid advancement of medical science, the high degree of specialization by physicians, the increasing need for technical assistants, and the need for expensive and elaborate equipment all depend on effective organization to assure efficient use. This ever-increasing complexity has brought about the growing professional occupation of hospital and health services managers.

In the past, physicians, nurses, or workers in other fields were appointed to the position of hospital administrator with little or no special training. The earliest recognition of hospital administration as a separate profession came in the 1890s when the Association of Hospital Superintendents was organized. This group, whose membership includes nearly all of the hospitals in the United States, is today known as the American Hospital Association. In the 1930s, the American College of Hospital Administrators (now the American College of Healthcare Executives) was founded to increase the standards of practice and education in the field.

The broad range of today's health care institutions includes general hospitals, medical group practices, extended care facilities, nursing homes, rehabilitation institutions, psychiatric hospitals, health maintenance organizations (HMOs), and outpatient clinics. The field of long-term care is one of the fastest growing parts of the industry; today, there are more than 15,700 nursing homes throughout the United States. About 36 percent of all health care managers work in hospitals, 11 percent work in offices of physicians, and 6 percent work in nursing care facilities.