Abstract
The introduction of professional-manager ‘hybrid’ roles has been seen as a solution to ‘bridge the gap’ between the two competing worlds of medicine and management (Freidson, 2001; Noordegraaf, 2007) at the organizational level. In particular, in a number of Western countries we observe doctors being involved in management as head of clinical directorates, which have become a popular object of analysis for management scholars (Fitzgerald and Dufour, 1998; Kitchener, 2000; Marnoch et al., 2000; Llewellyn, 2001; Kirkpatrick et al., 2009; Witman et al., 2011; McGivern et al., 2015). Clinical directorates are intermediate management units formed around either a broad medical specialty or a support service grouping a number of smaller specialties. They were introduced in order to increase the governance of clinical services, pool resources, favour inter-specialty integration and support the top management in the strategy making (Chantler, 1993; Kirkpatrick et al., 2013).
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References
Appelbaum, E., Bailey, T., Berg, P. and Kalleberg, A. (2000) Manufacturing Advantage: Why High-Performance Work Systems Pay Off. Ithaca: Cornell University Press.
Blumberg, M. and Pringle, C. D. (1982) ‘The missing opportunity in organizational research: some implications for a theory of work performance’, The Academy of Management Review, 7(4): 560–569.
Boselie, P. (2010) ‘High performance work practices in the health care sector: a Dutch case study’, International Journal of Manpower, 31(1): 42–58.
Boxall, P. and Purcell, J. (2011) Strategy and Human Resource Management, 3rd edition, Basingstoke and New York: Palgrave Macmillan.
Chantler, C. (1993) ‘Historical background: where have CDs come from and what is their purpose?’ in A. Hopkins (ed.), The Role of Hospital Consultants in Clinical Directorates. The Syncromesh Report. London: Royal College of Physicians.
Fitzgerald, L. and Dufour, Y. (1998) ‘Clinical management as boundary management, a comparative analysis of Canadian and U.K. healthcare institutions’, Journal of Management in Medicine, 12(4/5): 199–213.
Forbes, T., Hallier, J. and Kelly, L. (2004) ‘Doctors as managers: investors and reluctants in a dual role’, Health Services Management Research, 17(3): 167–176.
Freidson, E. (2001) Professionalism: The Third Logic. Chicago: University of Chicago Press.
Glouberman, S. and Mintzberg, H. (2001) ‘Managing the care of health and the cure of disease-part I: differentiation’, Health Care Management Review, 26(1): 56–69.
Gould-Williams, J. S. and Gatenby, M. (2010) ‘The effects of organizational context and teamworking activities on performance outcomes: a study conducted in England local government’, Public Management Review, 12(6): 759–787.
Ham, C. and Dickinson, H. (2008) Engaging Doctors in Leadership: What We Can Learn from International Experience and Research Evidence? London: NHS Institute for Innovation and Improvement.
Hoff, T. J. (2001) ‘Exploring dual commitment among physician executives in managed care’, Journal of Healthcare Management, 46(2): 91–111.
Kirkpatrick, I., Bullinger, B., Lega, F. and Dent, M. (2013) ‘The translation of hospital management reforms in European health systems: a framework for comparison’, British Journal of Management, 24: S48–61.
Kirkpatrick, I., Jespersen, P. K., Dent, M. and Neogy, I. (2009) ‘Medicine and management in a comparative perspective: the case of Denmark and England’, Sociology of Health and Illness, 31(5): 642–658.
Kitchener, M. (2000) ‘The “Bureaucratization” of professional roles: the case of clinical directors in UK Hospitals’, Organization, 7(1): 129–154.
Kvale, S. and Brinkmann, S. (2009) Learning the Craft of Qualitative Research Interviewing. California: SAGE Publications.
Lega, F. (2008) ‘The rise and fall(acy) of clinical directorates in Italy’, Health Policy, 85(2): 252–262.
Llewellyn, S. (2001) ‘Two way windows: clinicians as medical managers’, Organization Studies, 22(4): 593–623.
Marnoch, G., McKee, L. and Dinnie, N. (2000) ‘Between organizations and institutions: legitimacy and medical managers’, Public Administration, 78(4): 967–986.
McGivern, G., Currie, G., Ferlie, E., Fitzgerald, L. and Waring, J. (2015) ‘Hybrid manager-professionals’ identity work, the maintenance and hybridization of professionalism in managerial contexts’, Public Administration, 93: 412–432.
McKee, L., Marnoch, G. and Dinnie, N. (1999) ‘Medical managers: puppets or puppetmasters?’ in A. Mark and S. Dopson (eds.), Organisational Behaviour in Health Care: The Research Agenda. Basingstoke: Macmillan Press.
Neogy, I. and Kirkpatrick, I. (2009) Medicine in Management: Lessons across Europe. Leeds: Centre for Innovation in Health Management, University of Leeds.
Noordegraaf, M. (2007) ‘From “Pure” to “Hybrid” professionalism. Present-day professionalism in ambiguous public domains’, Administration & Society, 39(6): 761–785.
Numerato, D., Salvatore, D. and Fattore, G. (2011) ‘The impact of management on medical professionalism: a review’, Sociology of Health & Illness, 34(4): 626–644.
Peters, L. H. and O’Connor, E. J. (1980) ‘Situational constraints and work outcomes: the influences of a frequently overlooked construct’, The Academy of Management Review, 5(3): 391–397.
Sartirana, M., Prenestini A. and Lega F. (2014) ‘Medical management: hostage to its own history? The case of Italian clinical directors’, The International Journal of Public Sector Management, 27(5): 417–429.
Siemsen, E., Roth, A. V. and Balasubramanian, S. (2008) ‘How motivation, opportunity, and ability drive knowledge sharing: the constraining-factor model’, Journal of Operations Management, 26(3): 426–445.
Thorne, M. L. (1997) ‘Being a clinical director: first among equals or just a go-between?’ Health Services Management Research, 10(4): 205–215.
Weiss, R. S. (1994) Learning from Strangers: The Art and Method of Qualitative Interview Studies. New York: Free Press.
Witman, Y., Smid, G. A. C., Meurs, P. L. and Willems, D. L. (2011) ‘Doctor in the lead: balancing between two worlds’, Organization, 18(4): 477–495.
Yin, R. K. (2009) Case Study Research: Design and Methods. California: SAGE Publications.
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Sartirana, M. (2015). Opportunity Does Matter: Supporting Doctors-in-Management in Hospitals. In: Waldorff, S.B., Pedersen, A.R., Fitzgerald, L., Ferlie, E. (eds) Managing Change. Organizational Behaviour in Health Care Series. Palgrave Macmillan, London. https://doi.org/10.1057/9781137518163_11
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DOI: https://doi.org/10.1057/9781137518163_11
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