The rules of engagement: physician engagement strategies in intergroup contexts
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 11 March 2014
Abstract
Purpose
Recognition of the importance and difficulty of engaging physicians in organisational change has sparked an explosion of literature. The social identity approach, by considering engagement in terms of underlying group identifications and intergroup dynamics, may provide a framework for choosing among the plethora of proposed engagement techniques. This paper seeks to address this issue.
Design/methodology/approach
The authors examined how four disparate organisations engaged physicians in change. Qualitative methods included interviews (109 managers and physicians), observation, and document review.
Findings
Beyond a universal focus on relationship-building, sites differed radically in their preferred strategies. Each emphasised or downplayed professional and/or organisational identity as befit the existing level of inter-group closeness between physicians and managers: an independent practice association sought to enhance members' identity as independent physicians; a hospital, engaging community physicians suspicious of integration, stressed collaboration among separate, equal partners; a developing integrated-delivery system promoted alignment among diverse groups by balancing “systemness” with subgroup uniqueness; a medical group established a strong common identity among employed physicians, but practised pragmatic co-operation with its affiliates.
Research limitations/implications
The authors cannot confirm the accuracy of managers' perceptions of the inter-group context or the efficacy of particular strategies. Nonetheless, the findings suggested the fruitfulness of social identity thinking in approaching physician engagement.
Practical implications
Attention to inter-group dynamics may help organisations engage physicians more effectively.
Originality/value
This study illuminates and explains variation in the way different organisations engage physicians, and offers a theoretical basis for selecting engagement strategies.
Keywords
Acknowledgements
The authors gratefully acknowledge the financial support of The Commonwealth Fund; the funder had no role in the research process. The authors also thank Reena Kreindler for her editorial advice and transcription services, and Lisa Gray for additional transcription.
Citation
A. Kreindler, S., K. Larson, B., M. Wu, F., N. Gbemudu, J., L. Carluzzo, K., Struthers, A., D. Van Citters, A., M. Shortell, S., C. Nelson, E. and S. Fisher, E. (2014), "The rules of engagement: physician engagement strategies in intergroup contexts", Journal of Health Organization and Management, Vol. 28 No. 1, pp. 41-61. https://doi.org/10.1108/JHOM-02-2013-0024
Publisher
:Emerald Group Publishing Limited
Copyright © 2014, Emerald Group Publishing Limited