One aspect that may adversely affect the planning process is
associated with the relative lack of strategic thinking among the
health workers in the HO service.9
Healthcare professionals
manage short-term situations very effectively and make quick
decisions based on current diagnosis and treatment models and
algorithms, which serve as a guide in taking clinical decisions. The
long-term features very little in their daily work, which requires
practical and immediate answers to specific problems that are
usually tangible and quantifiable. Their work is usually efficient
within the known, due to its repetitive nature. In contrast,
physicians manage uncertainty and vagueness with difficulty and
do not go looking for problems as these tend to arrive on their
doorsteps and are usually routine. Physicians have a working
philosophy of ‘‘hands-on’’ and ‘‘first line of action.’’ Strategic
planning may presentthem with a challenge because they have to
face problems that are not well defined, have no known
precedents, evolve unpredictably, are barely quantifiable, and
yet require a response. Physicians have problems dealing with
ambiguity and problems that cannot be systematized.
To minimize any undesirable effects, the difference between
the professional skills specific to physicians in the HO services and
those required when they are placed in the position of participating in or leading a strategic plan should be taken into account.