The controllability (the grade of management decision implementation) is one of the integral indices of management efficiency for each company or organization. The purpose of the study is to investigate controllability of medical organizations and to stipulate the directions for its optimization.The anonymous questionnaire survey was carried on involving 92 medical managers selected by such criteria as professional experience, competence and agreement dimensions.The controllability in medical organization management was assessed including differential estimation by medical areas with the following outcomes. Most regularly, the decisions are taken by management staff are associated with treatment and diagnostic process, economic and financial areas. The role of the structure of non-effected decisions (44.3±5.2% - unexpected adverse events, 31.8±4.9 - low-levelled executive discipline, 23.9±4.5 - decision-making defects) was emphasized and such corresponding optimization directions as executive discipline enforcement; professional retraining of decision-makers; retrieval of timely, and complete information for decision-making; reinforced control of decision quality and implementation; improved motivation system for executives; inclusion of executes into decision-making process; increased innovative decision segment; maximally avoided double organizing measures and exclusion for decision documentation of purely mobilizing appeals; the combination of various management styles in the implementation process; the improvement of coordination of organizing mechanisms as well.The obtained results significantly contribute to the notion of medical institution controllability, directions and prospects of its optimization.The results of study can be implemented in everyday practice of medical institutions as well as in professional training of health care managers.