Ukraine introduces new healthcare roles: healthcare chief executive’s responsibilities to be distributed between executive director and medical director

Starting January 1, 2019, major responsibilities of a chief executive of a healthcare facility in Ukraine (previously, entirely assumed by physicians-in-chief) will be distributed between an executive director/director general (ExD) and a medical director (MeD). Accordingly, executive directors will be responsible for healthcare facility management and administration, while medical directors – for overall supervision and regulation of all medical processes and facets.

In Ukraine, physicians-in-chief of healthcare facilities have traditionally performed both managerial and medical functions. This is a huge amount of work, which is why in many developed countries these roles are distributed between two different healthcare facility managers – an executive director/director general and a medical director. An executive director of a healthcare facility assumes administrative and managerial responsibilities, including strategic planning, budget development, coordination of work and activities of all structural units, analysis of economic efficiency, investment attraction, etc. The role of a medical director is medical rather than managerial, as it envisages ensuring the provision of high quality patient-centered care, the development of cooperation among all medical departments and personnel, the introduction of modern diagnosis and treatment methods, as well as promoting professionalism and ethical values, continuing professional development of physicians and medical personnel, and continuous improvement of the institutional evidence-based healthcare system and policies.

Similar models have been successfully working in many countries, including the EU member states, for decades. In January 2019, this model will be introduced in Ukraine, and the transition process will be gradual. 

Pursuant to Order of the Ministry of Health of Ukraine No. 1977 dated October 31, 2018, no one will be fired in the process of implementation of these changes: all physicians-in-chief and other healthcare managers will continue performing their functions under the terms and conditions of their current employment contracts until they expire. For instance, all physicians-in-chief who will have concluded employment contracts by January 1, 2019, i.e. before the date on which the above-mentioned order enters into force, are to continue performing both managerial and medical functions during the contract period. When their contracts expire, they may participate in an open and transparent competition for the position of either executive director or medical director of a healthcare facility of their choice.

In 2019, the medical director profession will be introduced in the directory of healthcare professions.

Starting in 2022, all applicants for the position of healthcare facility executive director will be required to have a degree in Management and Administration or Public Management and Administration.