University hospitals in Japan are facing drastic changes in terms of its organization chart. The director of the hospital in Japan must be a physician by law. The director, however, has little skills regarding leadership and management. In order for university hospitals to survive, the assignment of two new staff authority positions are essential such as "the executive manager" and "the risk manager". Also, it is proposed that the Assistant Directors should be line authority positions. Management resources such as man, money and materials need to be utilized effectively and efficiently
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