Clinical Management and Professionalism

Abstract

A distinctive feature of new public management (NPM) reforms over the last two decades has been the drive to co-opt professionals such as clinicians, social workers, and teachers into the management of services. Profession- als taking on these roles have been considered ‘hybrids’, owing to the fact that they straddle both professional and managerial domains, often bridg- ing the gap between two occupational groups with different interests and priorities. In health services this trend has been especially pronounced with doctors becoming far more active in the strategic management of hospitals and other organizations, through membership of boards, but also at lower levels, working as clinical directors or general practitioners responsible for budgets to commission services. More recently there have been calls to encourage a wider constituency of clinical professionals, even those who do not become managers, to perform leadership roles. With many professional bodies them- selves now supporting these changes, it would seem that clinical leadership has moved from ‘the dark side to centre stage’ (Ham et al., 2011). Indeed, it may be increasingly problematic to view management and professionalism as opposing forces, as deeper connections emerge which are, arguably, leading to entirely new forms of ‘hybrid professionalism’ (Brommels, 2008; Kuhlmann et al, 2013).