Journal of Business Ethics

, Volume 123, Issue 1, pp 45–56 | Cite as

The Dilemma of Accountability for Professionals: A Challenge for Mainstream Management Theories

  • Maliheh Mansouri
  • Julie I. Adair Rowney


Professional institutions are increasingly confronted by fiscal constraints and political pressures to improve and increase their accountability in a competitive consumer-driven market. Accordingly, the need to ensure efficiency and accountability is of strategic importance. This article reports on a qualitative study of medical professionals that assessed the utility of financial incentives and external control methods derived from agency theory to ensure accountability of professionals. The authors argue that approaches derived from stewardship and institutional theories can extend the principal–agent perspective to sustain greater social and ethical accountability.


Accountability Agency theory Professionals Institutional theory Stewardship theory 


  1. Alberta Health Services (2013). Strategic Direction 2012-2015, Retrieved from
  2. Alexander, F. K. (2000). The changing face of accountability: Monitoring and assessing institutional performance in higher education. Journal of Higher Education, 71(4), 411–431.Google Scholar
  3. Allsop, J., & Mulcahy, L. (1996). Regulating medical work: Formal and informal controls. Berkshire: Open University Press.Google Scholar
  4. Armstrong, D. (1990). Medicine as a profession: times of change. BMJ, 301(6754), 691–693.Google Scholar
  5. Barney, J. (1990). The debate between traditional management theory and organizational economics: substantive differences or intergroup conflict? The Academy of Management Review, 15(3), 382–393.Google Scholar
  6. Bassiouni, M. C. (1996). Searching for peace and achieving justice: The need for accountability. Law and Contemporary Problems, 59(4/3), 9–28.Google Scholar
  7. Batson, C. (1991a). The altruism question: Toward a social psychological answer. Mahwah: Lawrence Erlbaum Associates.Google Scholar
  8. Batson, C. (1991b). Evidence for altruism: toward a pluralism of prosocial motives. Psychological Inquiry, 2(2), 107–122.Google Scholar
  9. Baur, D., & Schmitz, H. P. (2012). Corporations and NGOs: When accountability leads to co-optation. Journal of Business Ethics, 106(1), 1–13.Google Scholar
  10. Beecher-Monas, E. (2003). Enron, epistemology, and accountability: Regulating in a global economy. Indiana Law Review, 37, 141.Google Scholar
  11. Behn, R. D. (2001). Rethinking democratic accountability. Washington: Brookings Intuition Press.Google Scholar
  12. Bernard, C. (1938). The functions of the executive. Cambridge: Harvard University Press.Google Scholar
  13. Block, P. (1993). Stewardship: Choosing service over self-interest. San Francisco: Berrett-Koehler.Google Scholar
  14. Bovens, M. (1998). The quest for responsibility: Accountability and citizenship in complex organizations. Cambridge: Cambridge University Press.Google Scholar
  15. Bovens, M. (2006). Analysing and assessing public accountability. A conceptual framework. European Governance Papers (EUROGOV), 100, 1–37.Google Scholar
  16. Bovens, M. (2007). Analysing and assessing accountability: A conceptual framework1. European Law Journal, 13(4), 447–468. doi: 10.1111/j.1468-0386.2007.00378.x.Google Scholar
  17. Brandes, P., Dharwadkar, R., & Lemesis, G. (2003). Effective employee stock option design: Reconciling stakeholder, strategic, and motivational factors. Academy of Management Executive, 17(1), 77–95.Google Scholar
  18. Brehm, J., & Gates, S. (1997). Working, shirking, and sabotage: Bureaucratic response to a democratic public. Ann Arbor: University of Michigan Press.Google Scholar
  19. Brenkert, G. G. (2004). Corporate integrity and accountability. Thousand Oaks: Sage Publications.Google Scholar
  20. Burke, J. C. (2004). Achieving accountability in higher education: Balancing public, academic, and market demands. San Francisco: Jossey-Bass.Google Scholar
  21. Burke, J. C. (2005). The many faces of accountability. In Joseph C Burke (Ed.), Achieving accountability in higher education: Balancing public, academic and market demands (pp. 1–24). San Francisco: Jossey-Bass.Google Scholar
  22. Calnan, M. W., & Sanford, E. (2004). Public trust in health care: the system or the doctor? Quality and Safety in Health Care, 13(2), 92–97.Google Scholar
  23. Chaplowe, S. G., & Engo-Tjega, R. B. (2007). Civil society organizations and evaluation lessons from Africa. Evaluation, 13(2), 257–274.Google Scholar
  24. Charih, M., & Daniels, A. (1997). New Public Management and Public Administration in Canada: Toronto. ON: Institute of Public Administration of Canada/Institut d’administration publique du Canada.Google Scholar
  25. Corbett, D. (1996). Australian public sector management (2nd ed.). Sydney: Allen and Unwin.Google Scholar
  26. Cowen, T., & Glazer, A. (1996). More monitoring can induce less effort. Journal of Economic Behavior & Organization, 30(1), 113–123.Google Scholar
  27. Daniel, A., Burn, R., & Horarik, S. (1999). Patients’ complaints about medical practice. Medical Journal of Australia, 170(12), 598–602.Google Scholar
  28. Davis, G. (1991). Agents without principles? The spread of the poison pill through the intercorporate network. Administrative Science Quarterly, 583-613.Google Scholar
  29. Davis, J., Schoorman, F., & Donaldson, L. (1997). Toward a stewardship theory of management. The Academy of Management Review, 22(1), 20–47.Google Scholar
  30. Day, P., & Klein, R. (1987). Accountability: five public services. London: Tavistock Publications.Google Scholar
  31. De Cremer, D., & Dijk, E. (2009). Paying for sanctions in social dilemmas: The effects of endowment asymmetry and accountability. Organizational Behavior and Human Decision Processes, 109(1), 45–55.Google Scholar
  32. De Cremer, D., Snyder, M., & Dewitte, S. (2001). ‘The less I trust, the less I contribute (or not)?’The effects of trust, accountability and self-monitoring in social dilemmas. European Journal of Social Psychology, 31(1), 93–107.Google Scholar
  33. Denhardt, R., & Denhardt, J. (2000). The new public service: Serving rather than steering. Public Administration Review, 60(6), 549–559.Google Scholar
  34. Dicke, L. A. (2002). Ensuring accountability in human services contracting can stewardship theory fill the bill? The American Review of Public Administration, 32(4), 455–470.Google Scholar
  35. Dicke, L., & Ott, J. (1999). Public agency accountability in human services contracting. Public Productivity and Management Review, 22(4), 502–516.Google Scholar
  36. Dicke, L. A., & Ott, J. S. (2002). A test: can stewardship theory serve as a second conceptual foundation for accountability methods in contracted human services? International Journal of Public Administration, 25(4), 463–487.Google Scholar
  37. DiMaggio, P. (1988). Interest and agency in institutional theory. In Lynne G Zucker (Ed.), Institutional patterns and organizations: Culture and environment (pp. 3–21). Cambridge: Ballinger Pub. Co.Google Scholar
  38. DiMaggio, P., & Powell, W. (1991). The new institutionalism in organizational analysis. In Powell and P. DiMaggio (eds.), The new institutionalism in organizational analysis, Chicago, IL: University of Chicago Press.Google Scholar
  39. Donaldson, L. (1990). A rational basis for criticisms of organizational economics: A reply to Barney. The Academy of Management Review, 15(3), 394–401.Google Scholar
  40. Donaldson, L. (2001). Professional accountability in a changing world. British Medical Journal, 77(904), 65.Google Scholar
  41. Donaldson, L., & Davis, J. (1991). Stewardship theory or agency theory: CEO governance and shareholder returns. Australian Journal of Management, 16(1), 49–64.Google Scholar
  42. Drago, R., & Garvey, G. (1998). Incentives for helping on the job: Theory and evidence. Journal of Labor Economics, 16(1), 1–25.Google Scholar
  43. Drucker, P. (1993a). Managing for the future. Boston: Butterworth-Heinemann.Google Scholar
  44. Drucker, P. (1993b). Post-capitalist society. Oxford: Butterworth-Heinemann.Google Scholar
  45. Dubnick, M. J. (2003). Accountability and ethics: Reconsidering the relationships. International Journal of Organization Theory and Behavior, 6(3), 405–441.Google Scholar
  46. Dubnick, M. (2005). Accountability and the promise of performance: In search of the mechanisms. Public Performance &Management Review, 28(3), 376–417.Google Scholar
  47. Dubnick, M., & Yang, K. (2010). The pursuit of accountability: Promise, problems, and prospects. In Donald Menzel & Harvey White (Eds.), The State of Public Administration. Armonk: ME Sharpe.Google Scholar
  48. Durkheim, E., & Coser, L. A. (1997). The division of labor in society. New York: Free Press.Google Scholar
  49. Ebrahim, A. (2005). Accountability myopia: Losing sight of organizational learning. Nonprofit and voluntary sector quarterly, 34(1), 56–87.Google Scholar
  50. Eisenhardt, K. M. (1988). Agency- and institutional-theory explanations: The case of retail sales compensation. Academy of Management Review, 31(3), 488–511.Google Scholar
  51. Eisenhardt, K. M. (1989). Agency theory: An assessment and review. Academy of Management Review, 14(1), 57–74.Google Scholar
  52. Fisher, E. (2004). The European Union in the age of accountability. Oxford Journal of Legal Studies, 24(3), 495–515.Google Scholar
  53. Free, C., & Radcliffe, V. (2009). Accountability in crisis: The sponsorship scandal and the office of the comptroller general in Canada. Journal of Business Ethics, 84(2), 189–208.Google Scholar
  54. Freidson, E. (2001). Professionalism, the third logic: on the practice of knowledge. Chicago: University of Chicago Press.Google Scholar
  55. Gagne, R. L. (1996). Accountability and public administration. Canadian Public Administration, 39, 213–225.Google Scholar
  56. Giacomini, M., & Cook, D. (2000). Users’ guides to the medical literature XXIII. Qualitative research in health care A. Are the results of the study valid? JAMA, 284, 357–362.Google Scholar
  57. Glaser, B. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Mill Valley: Sociology Press.Google Scholar
  58. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine.Google Scholar
  59. Göbbels, M., & Jonker, J. (2003). AA1000 and SA8000 compared: a systematic comparison of contemporary accountability standards. Managerial Auditing Journal, 18(1), 54–58.Google Scholar
  60. Goldmann, D. (2006). System failure versus personal accountability—the case for clean hands. New England Journal of Medicine, 355(2), 121–123.Google Scholar
  61. Golembiewski, R. (1989). Toward a positive and practical public management organizational research supporting a fourth critical citizenship. Administration & Society, 21(2), 200–227.Google Scholar
  62. Gray, R. (2001). Thirty years of social accounting, reporting and auditing: what (if anything) have we learnt? Business Ethics: A European Review, 10(1), 9–15.Google Scholar
  63. Gray, R., Bebbington, J., & Collison, D. (2006). NGOs, civil society and accountability: making the people accountable to capital. Accounting, Auditing & Accountability Journal, 19(3), 319–348.Google Scholar
  64. Hall, A. T., Blass, F. R., Ferris, G. R., & Massengale, R. (2004). Leader reputation and accountability in organizations: Implications for dysfunctional leader behavior. The Leadership Quarterly, 15(4), 515–536.Google Scholar
  65. Hall, A. T., Bowen, M. G., Ferris, G. R., Royle, M. T., & Fitzgibbons, D. E. (2007). The accountability lens: A new way to view management issues. Business Horizons, 50(5), 405–413.Google Scholar
  66. Ham, C. (2002). The medical profession, the public, and the government. BMJ, 324(7341), 838–842.Google Scholar
  67. Harmon, M., & Mayer, R. (1986). Organization theory for public administration. Boston: Little, Brown.Google Scholar
  68. Harrison, S., & Ahmad, W. (2000). Medical Autonomy and the UK State 1975 to 2025. Sociology, 34(1), 129–146.Google Scholar
  69. Henry, V. E. (2002). The Compstat paradigm: Management accountability in policing, business and the public sector. Flushing: Looseleaf Law Publications Corporation.Google Scholar
  70. Hickson, G., Altemeier, W., & Perrin, J. (1987). Physician reimbursement by salary or fee-for-service: effect on physician practice behavior in a randomized prospective study. Pediatrics, 80(3), 344–350.Google Scholar
  71. Holmstrom, B., & Milgrom, P. (1991). Multitask principal-agent analyses: Incentive contracts, asset ownership, and job design. JL Econ. & Org., 7, 24.Google Scholar
  72. Huber, G., & Gordon, S. C. (2004). Accountability and coercion: Is justice blind when it runs for office? American Journal of Political Science, 48(2), 247–263.Google Scholar
  73. Irvine, D. (1997). The performance of doctors. I. Professionalism and self regulation in a changing world. BMJ, 314(7093), 1540–1542.Google Scholar
  74. Jabbra, J., & Dwivedi, O. (1988). Public service accountability. Sterling: Kumarian Press.Google Scholar
  75. Jensen, M., & Meckling, W. (1976). Theory of the Firm: Managerial Behavior, Agency Costs and Ownership Structure. Journal of Financial Economics3(4), 305-360.Google Scholar
  76. Jones, R. (1992). The development of conceptual frameworks of accounting for the public sector. Financial Accountability & Management, 8(4), 249–264.Google Scholar
  77. Jos, P. H., & Tompkins, M. E. (2004). The accountability paradox in an age of reinvention the perennial problem of preserving character and judgment. Administration & Society, 36(3), 255–281.Google Scholar
  78. Kernaghan, K., & Siegel, D. (1987). Public administration in Canada. Toronto: Methuen.Google Scholar
  79. Kettl, D. (1993). Sharing power: Public governance and private markets. Washington: Brookings Intuition Press.Google Scholar
  80. Kim, S. (2005). Balancing competing accountability requirements: Challenges in performance improvement of the nonprofit human services agency. Public Performance & Management Review, 29(2), 145–163.Google Scholar
  81. Klein, R. (1990). The state and the profession: the politics of the double bed. BMJ, 301(6754), 700–702.Google Scholar
  82. Larson, M. S. (1977). The rise of professionalism: A sociological analysis. Berkeley: University of California Press.Google Scholar
  83. Laufer, W. S. (2003). Social accountability and corporate greenwashing. Journal of Business Ethics, 43(3), 253–261.Google Scholar
  84. Lerner, J. S., & Tetlock, P. E. (1999). Accounting for the effects of accountability. Psychological Bulletin, 125(2), 255.Google Scholar
  85. Lingenfelter, P. E. (2003). Educational accountability: Setting standards, improving performance. Change: The Magazine of Higher Learning, 35(2), 18-23.Google Scholar
  86. Lofland, J., & Lofland, L. (1995). Analyzing social settings. Belmont: Wadsworth.Google Scholar
  87. Lucas, J. R. (1993). Responsibility. Oxford: Clarendon Press.Google Scholar
  88. Maile, S. (2006). Accountability: An essential aspect of school governance. South African journal of education, 22(4), 326–331.Google Scholar
  89. Margolis, H. (1984). Selfishness, altruism, and rationality: A theory of social choice. Chicago: University Of Chicago Press.Google Scholar
  90. Maycut, P., & Morehouse, R. (1994). Beginning qualitative research a philosophic and practical guide. London: Falmer Press.Google Scholar
  91. Mays, N., & Pope, C. (2000). Qualitative research in health care: Assessing quality in qualitative research. BMJ. British Medical Journal, 320(7226), 50.Google Scholar
  92. Mill, J. S. (1863). Utilitarianism. Parker, son, and Bourn, London.Google Scholar
  93. Mulgan, R. (2000). Accountability: An ever expanding concept? Public administration, 78(3), 555–573.Google Scholar
  94. Mulgan, R. (2003). Holding power to account: Accountability in modern democracies. Hampshire: Palgrave Macmillan.Google Scholar
  95. North, D. (1990). Institutions, institutional change and economic performance B2—Institutions, institutional change and economic performance. Cambridge: Cambridge University Press.Google Scholar
  96. O’Connell, Lenahan. (2005). Program accountability as an emergent property: The role of stakeholders in a program’s field. Public Administration Review, 65(1), 85–93.Google Scholar
  97. Owen, D. (2005). CSR after Enron: A role for the academic accounting profession? European Accounting Review, 14(2), 395–404.Google Scholar
  98. Parker, L. D. (2005). Corporate governance crisis down under: post-Enron accounting education and research inertia. European Accounting Review, 14(2), 383–394.Google Scholar
  99. Parks, J., & Conlon, E. (1995). Compensation contracts: Do agency theory assumptions predict negotiated agreements? The Academy of Management Journal, 38(3), 821–838.Google Scholar
  100. Patton, M. Q. (2002). Qualitative research and evaluation methods. Thousand Oaks: Sage Publications.Google Scholar
  101. Paul, S. (1991). Accountability in Public Services: Exit, Voice, and Capture. Washington, D.C.: Country Economics Dept., World Bank, Issue 164.Google Scholar
  102. Perrow, C. (1986). Complex organizations: A critical essay. Glenville: Scott, Forseman & Co.Google Scholar
  103. Pettigrew, A. (1992). On studying managerial elites. Strategic Management Journal, 13, 163–182.Google Scholar
  104. Pettigrew, A., Ferlie, E., & McKee, L. (1992). Shaping strategic change: making change in large organizations: the case of the National Health Service. Thousand Oaks: Sage.Google Scholar
  105. Pfeffer, J. (1998). The human equation: Building profits by putting people first. Boston: Harvard Business School Press.Google Scholar
  106. Pratt, J., & Zeckhauser, R. (1996). Willingness to pay and the distribution of risk and wealth. The Journal of Political Economy, 104(4), 747–763.Google Scholar
  107. Rasche, A., & Esser, D. E. (2006). From stakeholder management to stakeholder accountability. Journal of Business Ethics, 65(3), 251–267.Google Scholar
  108. Robinson, P. (2003). Government accountability and performance measurement. Critical Perspectives on Accounting, 14(1), 171–186.Google Scholar
  109. Romzek, B. S. (1998). Where the buck stops: Accountability in reformed public organizations. In Ingraham, Thompson and Sanders (eds), Transforming government: Lessons from the reinvention laboratories, (pp. 193-219). San Francisco, CA: Jossey-Bass.Google Scholar
  110. Romzek, B. S. (2000). Dynamics of public sector accountability in an era of reform. International Review of Administrative Sciences, 66(1), 21–44.Google Scholar
  111. Romzek, B. S., & Dubnick, M. J. (1987). Accountability in the public sector: Lessons from the challenger tragedy. Public Administration Review, 47(3), 227–238.Google Scholar
  112. Romzek, B. S., & Dubnick, M. J. (1998). Accountability. International encyclopaedia of public policy and administration, 1, 6.Google Scholar
  113. Romzek, B. S., & Johnston, J. M. (2005). State social services contracting: Exploring the determinants of effective contract accountability. Public Administration Review, 65(4), 436–449.Google Scholar
  114. Rose-Ackerman, S. (1996). Altruism, nonprofits, and economic theory. Journal of Economic Literature, 34(2), 701–728.Google Scholar
  115. Rosenthal, M. (1995). The incompetent doctor: behind closed doors. Berkshire: Open University Press.Google Scholar
  116. Rosenthal, M. (1997). Promise and Reality: Professional Self-Regulation and ‘Problem’ Colleagues. In P. Lens & G. van der Wal (Eds.), Problem doctors: A conspiracy of silence (pp. 9–29). Amsterdam: IOS Press.Google Scholar
  117. Rothstein, R., Jacobsen, R., & Wilder, T. (2008). Grading education: Getting accountability right. Washington: Economic Policy Institute.Google Scholar
  118. Rowe, J. W. (2006). Pay-for-performance and accountability: related themes in improving health care. Annals of Internal Medicine, 145(9), 695.Google Scholar
  119. Schedler, A. (1999). Conceptualizing accountability. In Andreas Schedler, Larry Diamond, & Marc F Plattner (Eds.), The self-restraining state: Power and accountability in new democracies (pp. 13–28). Boulder and London: Lynne Rienner.Google Scholar
  120. Sedikides, C., & Herbst, K. C. (2002). How does accountability reduce self-enhancement?: The role of self-focus. Revue internationale de psychologie sociale, 15(3/4), 113–128.Google Scholar
  121. Sharma, A. (1997). Professional as agent: Knowledge asymmetry in agency exchange. The Academy of Management Review, 22(3), 758–798.Google Scholar
  122. Shell, R. (2003). Management of Professionals (2 ed.). New York. Basel: Marcel Dekker Inc.Google Scholar
  123. Simon, H. (1993). Altruism and economics. The American Economic Review, 83(2), 156–161.Google Scholar
  124. Sinclair, A. (1995). The chameleon of accountability: forms and discourses. Accounting, Organizations and Society, 20(2), 219–237.Google Scholar
  125. Smith, R. (1989). Profile of the GMC: The day of judgment comes closer. BMJ, 298(6682), 1241–1244.Google Scholar
  126. Solomon, J. (2011). Corporate governance and accountability. West Essex: Wiley.Google Scholar
  127. Stearns, S., Wolfe, B., & Kindig, D. (1992). Physician responses to fee-for-service and capitation payment. Inquiry, 29(4), 416–425.Google Scholar
  128. Swift, T. (2002). Trust, reputation and corporate accountability to stakeholders. Business Ethics: A European Review, 10(1), 16–26.Google Scholar
  129. Valor, C. (2005). Corporate social responsibility and corporate citizenship: Towards corporate accountability. Business and Society Review, 110(2), 191–212.Google Scholar
  130. Van Wart, M. (1998). Changing public sector values. New York: Garland.Google Scholar
  131. Vidovich, L., & Slee, R. (2001). Bringing universities to account? Exploring some global and local policy tensions. Journal of Education Policy, 16(5), 431–453.Google Scholar
  132. Weber, M. (1947). The theory of economic and social organization. Trans. AM Henderson and Talcott Parsons. New York: Oxford University Press.Google Scholar
  133. Weber, M. (1968). Economy and society. New York: Bedminster Press Incorporated.Google Scholar
  134. Weber, E. P. (1999). The question of accountability in historical perspective from jackson to contemporary grassroots ecosystem management. Administration & Society, 31(4), 451–494.Google Scholar
  135. West, W. F. (2004). Formal procedures, informal processes, accountability, and responsiveness in bureaucratic policy making: An institutional policy analysis. Public Administration Review, 64(1), 66–80.Google Scholar
  136. Wiseman, R., & Gomez-Mejia, L. (1998). A behavioral agency model of managerial risk taking. The Academy of Management Review, 23(1), 133–153.Google Scholar
  137. Wolfe, A. (1998). One nation, after all: what middle-class Americans really think about: God, country, family, racism, welfare, immigration, homosexuality, work, the right, the left, and each other. New York: Viking.Google Scholar
  138. Young, D. R. (2002). The influence of business on nonprofit organizations and the complexity of nonprofit accountability looking inside as well as outside. The American Review of Public Administration, 32(1), 3–19.Google Scholar
  139. Zey, M. (1998). Rational choice theory and organizational theory: A critique. Thousand Oaks: Sage Publications.Google Scholar

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© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.University of LethbridgeCalgaryCanada
  2. 2.Haskayne School of BusinessUniversity of CalgaryCalgaryCanada

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