Clinicians and the governance of hospitals: A cross-cultural perspective on relations between profession and management

Degeling, Pieter; Zhang, Kai; Coyle, Barbara; Xu, Lingzhong; Meng, Qingyue; Qu, Jiang-Bin; Hill, Michael

doi:10.1016/j.socscimed.2006.01.034

Cited by 54 publications

(58 citation statements)

References 28 publications

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“…Recently, scholars presented findings challenging this assumption (Degeling et al 2006;Filc 2006;Fitzgerald and Ferlie 2000;Jacobs 2005;Kirkpatrick et al 2007;Kirkpatrick et al 2009;Kitchener 2000;Kurunmäki 2004;Llewellyn 2001). Rather, they stress a focus on doctors' agency, mindful of national conditions, histories and trajectories either fostering or closing off opportunities for doctors to dominate management work (Kirkpatrick et al 2007).…”

Section: Situating the Problemmentioning

confidence: 99%

The Medical Council in Belgian hospitals: A political perspective

Gourdin

Schepers

2011

Management & Organizational History

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Archetype-theory gained prominence in the literature dealing with the ‘‘managerialization’’ of professional organizations. However, this theory has been criticized. Due to its functionalist legacy it underplays the role of agency in the organizational structure or in its change. Following this critique we develop a political perspective on the relation profession — management. Such a view stresses the interlocking of organization and domination. However, control does not just apply to workers and work, a ‘rule by rules’ implies rulers are also object of regulation. Agency will be directed at having an impact on rule creation. In the end organizational structure is designed to control the agency of both profession and management. The elaboration of structure is not to be seen as a function of the qualities of work, or of organizational performance. Rather our analysis of the genesis of the medical council in Belgian hospitals suggest that it results out of agency within a specific policy process.

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Section: Situating the Problemmentioning

confidence: 99%

The Medical Council in Belgian hospitals: A political perspective

Gourdin

Schepers

2011

Management & Organizational History

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“…health care decisions, at least to some extent, will be made collectively and that this could reduce perceived clinical autonomy (Degeling et al, 2006).…”

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confidence: 99%

Consequences of Participating in Multidisciplinary Medical Team Meetings for Surgical, Nonsurgical, and Supporting Specialties

Molleman¹,

Broekhuis²,

Stoffels

et al. 2009

Med Care Res Rev

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This study examines the consequences for medical specialists of participating in multidisciplinary medical team meetings in terms of perceived clinical autonomy, domain distinctiveness, and professional accountability. These consequences may influence their willingness to cooperate and the quality of teamwork. The authors hypothesized that multidisciplinary medical team meetings would be more of a threat to the professional identity of surgical specialists than to the professional identity of nonsurgical and supporting specialists. A survey among 1,827 Dutch medical specialists supported the authors' hypotheses. However, a few specific specialties had response patterns that deviated from our expectations. The results are related to specialty choice, to the training of medical specialties, and to having a role in leading team meetings.

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“…Many papers were found on the increased interdependence between physicians and managers resulting from the increased dominance of the business-like healthcare logic (Castellani & Wear, 2000;Degeling et al, 2006;Kaissi, 2005;Lega & Depietro, 2005;Som, 2005;Sutherland & Dawson, 1998;Warwicker, 1998). Although medical dominance is reported to remain strong in key areas of technical and clinical autonomy (Abernethy, 2004;Currie, Humpreys, Waring, & Rowley, 2009;Fitzgerald & Ferlie, 2000;Klopper-Kes, Meerdink, van Harten, & Wilderom, 2009;McDonald, Waring, & Harrison, 2006;Succi, Lee, & Alexander, 1998), it is a source of strain and interest dissatisfaction among physicians (Thorne, 2002).…”

Section: Figure 1: Review Model Of Intra-organizati Onal Dynamics As mentioning

confidence: 99%

“…Summarizing, although no studies were found dealing with interest dissatisfaction among hospital managers, convincing data on the relation between power dependency and interest dissatisfaction among physicians was found in the surveys of Degeling (2006) andPaul Leigh (2002), and the case studies described by Cohn (2005) Nine papers were found dealing with the relation between power dependencies and value commitments in hospitals. An overview of the review results is included in Table 2, which is available as a web-accessible file (Appendix A).…”

Section: Figure 1: Review Model Of Intra-organizati Onal Dynamics As mentioning

Clinicians and the governance of hospitals: A cross-cultural perspective on relations between profession and management

Cited by 54 publications

References 28 publications

The Medical Council in Belgian hospitals: A political perspective

The Medical Council in Belgian hospitals: A political perspective

Consequences of Participating in Multidisciplinary Medical Team Meetings for Surgical, Nonsurgical, and Supporting Specialties

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