PRINCIPLES OF ADMINISTRATION

BY
N.NITYA KRISHNA
2ND YEAR POSTGRADUATE
DEPARTMENT OF PUBLIC HEALTH DENTISTRY
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 CONTENTS

Introduction
History
Definitions
General principles of administration
Principles of Administration In Dental Public Health
1. Administrative organization
2. Executive management
Conclusion
References

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 INTRODUCTION
The Dentist with a leadership role - principles by which large
enterprises are administered, whether by the governmental
or private.

Small number of workers-control

Should know about the general principles of administrative

organization and management which come definitely within
his area of responsibility

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 History
1491 B.C. Moses - During the exodus from Egypt Moses followed the
recommendation of Jethro, his father-in-law, that he delegate authority over the
tribes of Israel along hierarchical lines.

400 B.C. Plato-Recognized management as a separate art; promoted principles of

specialization.

325 B.C. Alexander the Great - Applied the principle of line and staff to help
conquer most of the known world.

284 A.D. Diocletian - First Roman emperor to rule through genuine delegation of
authority and chain of command. He divided the empire into 101 provinces,
grouped into 13 dioceses; the dioceses, in turn, were organized into four major
geographic divisions.
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1810 Robert Owen - Recognized need for training workers and other personnel
practices.

1850 John Stuart Mill - Explained concepts such as span of control, unity of
command, and wage incentives.

1856 Daniel C. McCallum - On October 5, 1841 two American passenger trains

collided head-on, making it clear that one boss could not watch everything. A well-
defined organizational structure was needed, and McCallum developed the
organization chart to show that structure

1938 Chester I. Barnard - Viewed organizations as cooperative systems in which

the "functions of the executive" (title of his classic work) were to maintain a
balance between the needs of the organization and the needs of the individual and
to establish effective communication. 5
 Principle
Definitions
A fundamental truth or proposition that serves as the foundation for a system of
belief or behaviour or for a chain of reasoning.

Administration
Is the direction, coordination & control of many persons to achieve some purpose
or objective.
L.D.White

Management
Means to forecast, and plan, to organize, to command, to coordinate and to
control
Henry Fayol
Organization
Is the process of identifying and grouping work to be performed, defining and
delegating responsibility and authority and establishing relationships for the
purpose of enabling people to work most effectively together in accomplishing
objectives.
Louis Allen
 General Principles Of Administration
According to Henry fayol,
Administration comprises of 14 elements:
1. Division of Work
2. Authority, Responsibility and Accountability
3. Discipline
4. Unity of Command
5. Unity of Direction
6. Subordination of individual interest to general interest
7. Remuneration
8. Centralization
9. Scalar chain of Command or Hierarchy
10. Order
11. Equity
12. Stability of Tenure
13. Initiative
14. Espirit de Corps (Union is strength) 7
 Principles of Administration In Dental Public
Health
There are 2 main areas into which administrative work may be divided:

1. Organization- which deals with the structure of an agency and the way
people are arranged into working groups within it.

2. Management- concerned with handling of personnel and operations in

such a way that the work of the agency gets done.

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 Administrative Organization
Well - established principles of organization- essential
Dentist - armed forces-characteristic of military life.

1. Centralized authority
2. Span of control
3. Delegation
4. Autonomy
5. Budgeting
6. Grantsmanship
7. Expenses

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 Centralized authority
Top- position of executive responsibility

Centralized control-efficient communication

Orders dealing with the conduct of the enterprise

must come from one source

Sub leaders in the enterprise- for orders and

guidelines and must also be responsible for
communicating clearly with those subordinates

Popular control-legislative branch-planning

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 Private enterprise-board of directors and
advisory committees

Dental school Deans office receive and

redirect to the proper source all requests for
information

Handling of information-various directions

administrative organization

Executive-plan work-perspective

Help to the public-conduct of the enterprise

rests.

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 Span of control
Foreman of group- 20 or 30 people- same
operation

Executive-8-12 immediate subordinates-

different administrative problem-
coordinated enterprise.

Deputies-responsible to the chief handling

of group.

Enterprises of any size-logical-line and staff

services or functions.

line-disease control, dental health, sanitary

engineering-in charge-carry the services - to
public.

Staff- personnel, finance and other services

organization-operating entirely within it. 12
 Some staff-technical-services outside organization-health educator-lent by a
state to the local area-responsible to line health officer.

Dental officer-works entirely within the organization- alongside the medical

officer, chaplain, engineer, supply officer.

Functions of executive

The last function-pageantry.

People -symbols-organization-in charge of the organization
Person best qualified to describe it and its activities -image.

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 Delegation
The larger the enterprise the more work-to direct it
and operate it
Necessary work, authority, responsibility and the
pride and the credit that go with it.

Andrew Carnegie- reputed to have made policy never to

do anything he could hire someone else to do for
him.

He was careful also to treat his subordinates in such

a way that they would take adequate pride in their
work and have authority enough to perform it.

According to Dimock
1. It is generally agreed that in order to obtain best
results, the authority must equal the responsibility
vested in a person when delegation is made.

2. There is no substitute for an executive riding herd

on his own supervisory function. He can delegate
many other things but not this one.
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Complications-
Subordinates - leader to be able and perform, within reason, the task he delegates.
The best leader for small teams of dentists -not only is known to be a good
operator himself but is willing to take- operating load.

Larger the organization-administration becomes a full time job-executive to

devotee his entire skill and attention to this task.

Attitude of an executive takes toward his subordinates can become a matter of

administrative policy.

The citizenship conception of labor- Scott and his coauthors-

Not only are workers human beings and to be treated as such, but they are also a
part of the enterprise to which they have sold their labor.

Just as citizens automatically have certain inherent rights and a voice in

determining and exercising those rights, so are workers, as citizens of the industry
in which they are employed, entitled to the same right of having a voice in
determining the rules and regulations under which they work. 15
 Autonomy
Dentists-free of the control of others-professional quality.
Arisen historically-physicians-underestimate the physiological importance
of the dental care and the skill and training needed in order to render it.
Military dental services- responsible directly to line officer.

Advantages
Dentist has an independence
Disadvantages
It impairs coordination- cases involving maxillofacial surgeries.

In public health departments, dental autonomy is sufficiently achieved by

separate divisional status.

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 Techniques Of Executive Control
Larger the organization-more detailed techniques.
Certain techniques-small units- dental public health.

Detailed analysis of the

Handling of complex
working of the organization
situations
Deal with technical
Valuable-complicated or
matters.
unusual functions to be
Dimock- ease
performed
misunderstanding of written
communication.

.
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 Budgeting
Public health dentist-less concern with the process of budgeting.
It has been called a plan of work with dollar signs attached.

Preparation of the budget forces an executive to define first the objective of the
enterprise and then the basic units which will compose it.

Budget when completed , will describe the enterprise to the public, not in full
perspective, but at least in terms of the most important medium through which
public support is rendered.

The usual construction of a budget involves attention both to sources of money

and to expenditure.
On the income side there is often a division into what is called hard money
and soft money.
Hard-main supply of funds from parent organization, from endowment, or from
conservative estimate of fees or reimbursements of services rendered.
Soft-gifts or grants for immediate use.
Given for limited time-indefinite renewals cannot be expected.
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 Grantsmanship
Grantsmanship is the art of acquiring peer-reviewed research funding.

Grants provide money and other resources to aid and assist organizations

Agencies and governments offer the opportunity to receive funding for specific
types of studies and research each year to individuals, public agencies, schools,
non-profit organizations, and corporations.

A complex and all-encompassing application must be completed in order.

The person who writes the grant is called the grant writer.

Ever increasing dependency of health agencies and health educational

institutions upon grant money makes it inevitable that the success of an
executive in theses field be measured to some extent
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 There are several components included in all grant
proposals.

An abstract, narrative, literature review and/or

data, and methodology are included in all proposals.

Some grant funders require more information in a

proposal.

Many funding agencies now require that applicants

include an evaluation plan.

Additional information that might be required is

data analysis, time tables, letters of support, or
plans for dissemination.

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 Experimental - After explaining each experiment,
restate the point of completing this activity and
main purpose.

At the end of the methodology section, it is

import for the writer to summarize how all of the
experiments converge.

Exploratory or Descriptive work - the grant

writer should explain the intrinsic value of
research and the theoretical relevance.

The grant writer should explain - significant to

the field being studied, the method of
organization to be used, the potential users, and
how the new book will be better than existing
ones

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 Expenses
Expense budgets are usually constructed in terms of salaries for
personnel, together with appropriate retirement allowances and sums of
money.

COST-ACCOUNTING
Attempts to allocate appropriate costs to the different functions.
A dental health service estimate money-health education, case
finding, restorative dentistry and administration.

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Cost- Benefit Analysis
The economic benefits of any programme are compared with the cost of that
programme. The benefits are expressed in monetary terms to determine
whether a given programme is economically sound, and to select the best out
of several alternate programmes.

The total cost of a disease per case is estimated both directly (in terms of the
cost of treating it) and indirectly (in terms of the money lost to the patient
and to society as a result of the ensuing disability)

The net benefit to society is the gross cost of the disease, less the cost of
control or eradication.

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Cost Effective Analysis
It is similar to cost-benefit analysis except that benefit, instead of being
expressed in monetary terms is expressed in terms of results achieved.

Two general words of warning:

1. Danger of tailoring an administrative organization to the personality of
any one official or member of it, to the exclusion of good long range
planning.

2. Parkinsons law work expands so as to fill the time available for its
completion.

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 Executive Management
Executive management-active and interesting experience in human relations.

Personnel management-worker-in-his-work-unit.

Worker-thought in terms of his capacities, interests and opportunities.

Good recruitment procedure

Attempts to measure the interest of the employee in his job inevitably call for an
analysis of incentives most educated people find in their work.

Dimock -4 main incentives-financial gain, prestige, power and public service.

Good working condition included in incentives - attractive quarters, good

equipment, congenital associates, good working hours and fair vacations
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 Annual vacation-full pay should be planned.

Undue laxity-avoided- both the work and the morale-suffer

Five principles of personnel management

1. Good recruitment and careful selection of workers
2. Sound classification of jobs-order of rank-accurate written description of
duties
3. Equitable pay scales
4. Provision of tenure
5. Adequate provisions for separation and retirement.

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 Executive management deals with
1. Program evaluation
2. Consultation work
3. Qualification and training of personnel
4. The executive

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 Program Evaluation
Any health service-initial planning effort

Periodic appraisal and replanning

The term operations research and systems engineering have

been advised to cover a large range of techniques in this
area.

Some items input and output are measurable.

Mathematical models, graphic models or flow charts-help in

this situations.

Subjective evaluation-efficacy of the operation.

Subjective assessment-quality of output

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 Operation research-analytical discipline.

System engineering-construction one.

Flagle, Huggins and Roy list a wide variety of hospital problems.-operation

research.

One specific approach-operation research- PERT (Program Evaluation and

Review Technique)- preparation of drawings-flow of operations.

Programs evaluated-results-changes in attitudes or behavioral patterns.

Questionnaires-valuable.

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 Consultation Work
A consultant is a professional who provides expert advice
but no authority to give orders.

Confined to informal conversations, but a planned structure

gives the relationship a lot more meaning.

Nowjack-Raymer- duties of dental hygienists- act as a

consultant to the classroom teachers in Project
Headstart-5 stages in the process
1) Early contact during the planning stages of the classes.
2) Collection of data relevant to children's oral health
3) Feedback and decision as to recommendations for
action
4) Implementation
5) Extension, recycling, or termination of the relationship

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 Qualifications and Training of Personnel
The field of dental public health can be approached through various channels
of education and accreditation.

For dentists, the first of the channels-degree of Master of Public Health

(M.P.H), involving one or two years.

Courses offered- biostatistics, epidemiology, behavioral science, and health

service administration build well on the courses offered for a dental degree.

With this preparation the dentist should qualify for a wide range of health care
administrative and teaching assignments.

Equivalent degrees to M.P.H- valuable, if less general, preparation

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 Top level dental public health-certification American Board of Dental Public
Health.

This board requires - Dental graduation

M.P.H degree or an equivalent
Licensure in at least one state
Total of six years of graduate education and field
experience including residency.

Final step-examination and 2 project reports.

One difficulty- certification-requirement of current activity which is limited to

full-time specialization in administration, teaching, and clinical practice or
research related to dental public health or preventive dentistry.

Clinical dentists-recruited for service in public agencies-with a dental degree

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 Dental hygienists- clinical assignments-certification -2 years of training.

Hygienists teaching, case finding etc-4 years of training- Bachelor of

Science or Dental Hygienist degree.

Residency-increasingly careful structure-medicine and dentistry.

The American Board of Dental Public Health is working with American

Dental Association to elaborate and apply accreditation procedures for
dental public health residency.

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 The Executive
No complete listing-charactrisitcs
a) Good executive
b) Control techniques that might be expected to employ.

Schell listed a number of qualities of unquestionable value to an executive:

1. Enthusiasm for his work
2. Cheerfulness
3. A receptive attitude towards employs and their problems.
4. Frankness
5. Impressiveness
6. Firmness
7. Tolerance
8. Tact
9. Friendliness or kindness.

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 Important to remember peoples names and to make them feel at ease-
complete cooperation

A principle test of an executives leadership according to Dimock ability to

step in unobtrusively at the right moment and supply an instruction or
suggestion when greater knowledge of the overall situation, or a sense of
strategy reveals the necessity.

The executive does his most effective work when the sub executive has
contributed everything of which he is capable of and need extra 5% of
knowledge and leadership with which to turn out a workmanlike job.

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Communication-characteristic feature
Barnards four requirements for an authoritative communication are:
1. Communication must be understood
2. Must seem consistent with the purposes of the organization at the time
3. Compatible with the personal interest of the recipient at the time
4. If its an order-the recipient mentally and physically able to comply.

Sir William Osler- advices as applicable to the executive as to the physician:

You cannot afford to stand aloof from your professional colleagues in any
place. Join their associations, mingle in their meetings, giving of the best
of your talents , gathering here, scattering there; but everywhere showing
that you are at all times faithful students, as willing to teach as to be
taught.

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 A subordinate should never be criticized.

The person taken to task is thinking so much of the effect this criticism will
have upon his standing among his peers that his resentment blocks his
understanding of the criticism.

At times public correction needed-subordinate-simple way to do proper

thing.

It also helps apologize afterward when one has been forced to correct a
subordinate in public, and to reach an understanding with the employee so
that the situation will not occur in the future.

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Responsibility of an executive-
Every executive possesses- personal moral codes.
1. The government code applying to his company, that is, the laws, charter,
provisions, etc.;
2. Obedience to the general purpose and general methods including the
established systems of objective authority.
3. The general purpose of his department
4. The general moral standards of his subordinates
5. The technical situation as a whole
6. The code of the informal executive organization
7. The code that is suggested in the phrase the good of the organization as
a whole;
8. The code of the informal organization of the department;
9. The technical requirements of the department as a whole

Acc to Barnard-main function of the executive-reconciling of the plans for

action with as many of these moral codes as may be involved.

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 CONCLUSION
Administration is a combination of purpose and means of achievement of
that purpose.

Dental public health administration results in output of the patient whose

health and oral cavity is maintained or improved through input of personnel
and material resources in orderly process.

Management is the process of getting work done by others.

Dental public health management is the process of working, through

personnel to provide care, cure and comfort to group of patients.

Manager /supervisors task is to plan, organize, direct and control available

financial , material and human resources in order to provide effective,
economic care to group of patient

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 References
Dunning JM. Principles of dental public health. 4th ed. London: Harvard
University Press; 1986.p.208-229.

Starling G. Managing the public sector. 9th ed. Wadsworth: Suzanne Jeans;
2010.p. 1-16.

Hughes OE. Public management and administration. 3rd ed. Houndmills:

Palgrave Macmillan; 2012.p. 1-17.

Godfrey PC, Mahoney JT. The functions of the executive at 75: An invitation
to reconsider a timeless classic. J Manag Inq 2014 Oct;23(4): 360-72.

Park K. Textbook of preventive and social medicine. 23rd ed. Jabalpur:

Bhanot publishers; 2015. p. 868-890

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