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Attempts to address the question of managerial effectiveness in the UK′s National Health Service, with particular reference to doctors holding managerial positions as clinical directors. Emphasizes a systems framework as a model for analysis of the concept of effectiveness. Identifies and discusses the importance of various managerial inputs(for example, managerial behaviour) and outputs such as objectives in business plans. Highlights the difficulty of establishing outcome measures in a service organization. Contrasts this approach with an alternative subjectivist approach which questions the validity of objective measures of effectiveness. The two approaches are not necessarily incompatible but require a convergence in the philosophical assumptions underpinning analysis. May be relevant to medical managers and other professionals acting as managers in service organizations.

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