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Physicians are instrumental in healthcare reform and their capacity to employ both leadership and management skills can affect change at all levels. This paper aims to present the challenges and opportunities for physicians in influencing system change and discuss how the two different but complementary skill sets may enable them to contribute to transformation of healthcare.

This is a conceptual paper and represents the viewpoints of both authors while incorporating current evidence through the literature.

Healthcare reform is important and underway in many Canadian provinces, yet it is difficult to achieve change. Leadership and management skills differ although these differences are often subtle in language. Physicians both lead and manage in the healthcare system; their capacity to do both is an advantage for healthcare reform.

This paper represents the opinions of both authors and is considered original as a conceptual paper.

The authors contribute to practice-driven institutionalism by examining how the introduction of new field-level evaluation practices may facilitate encroachment of highly institutionalized organizational fields by new institutional logics. The authors conducted an inductive study of a trial of social impact bonds in the field of social integration services in Finland. Our analysis elaborates how new field-level evaluation practices created an experimental space that induced organizational practice experimentation, reconfigured relationships among field members, and lowered the barriers to entry for new organizations. The authors theorize how evaluation practices may create experimental spaces by suspending the carriers of established logics and legitimizing institutional innovations. The authors further elaborate how such spaces can bring about a parallel “shadow field” by inducing bottom-up experimentation aligned with a new institutional logic.

We have been working together for more than 40 years with some success. In this chapter, we use that lengthy collaboration to suggest what elements and processes have been important for us, and, which we believe are important for working together more generally. These include: the local environment for collaborative research; the dynamics of an ongoing collaboration; the process of managing collaboration; the impact of personal styles; the changing nature of collaboration the longer it continues; the impact of career changes; and the role of successful outcomes. We examine what lessons we have learned and make some observations about our experience in relation to more general ideas about collaboration.

This double volume presents state-of-the-art research and thinking on the dynamics of actors and institutional logics. In the introduction, we briefly sketch the roots and branches of institutional logics scholarship before turning to the new buds of research on the topic of how actors engage institutional logics in the course of their organizational practice. We introduce an exciting line of new works on the meta-theoretical foundations of logics, institutional logic processes, and institutional complexity and organizational responses. Collectively, the papers in this volume advance the very prolific stream of research on institutional logics by deepening our insight into the active use of institutional logics in organizational action and interaction, including the institutional effects of such (inter)actions.

Undoubtedly, digital transformation is permeating all domains of business and society. We envisage this volume as an opportunity to explore how manifestations of digital transformation require rethinking of our understanding and theorization of institutional processes. To achieve this goal, a collaborative forum of organization and management theory scholars and information systems researchers was developed to enrich and advance institutional theory approaches in understanding digital transformation. This volume’s contributions advance the three institutional perspectives. The first perspective, institutional logics, technological affordances and digital transformation, seeks to deepen our understanding of the pervasive and increasingly important relationship between technology and institutions. The second perspective, digital transformation, professional projects and new institutional agents, explores how existing professions respond to the introduction of digital technologies as well as the emergence of new professional projects and institutional agents in the wake of digital transformation. The third perspective, institutional infrastructure, field governance and digital transformation, inquires how new digital organizational forms, such as platforms, affect institutional fields, their infrastructure and thus their governance. For each of these perspectives, we outline an agenda for future research, complemented by a brief discussion of new research frontiers (i.e., digital work and sites of technological (re-)production; artificial intelligence (AI) and actorhood; digital transformation and grand challenges) and methodological reflections.

This chapter examines the sources of variation in organizational form among accounting and law firms. We first summarize research in the organization of professional service firms and explain its evolution. This is followed by the argument that variations around the P2 archetype have emerged in response to different market and institutional pressures faced by accounting and law firms. Drawing on contingency and institutional theory, we show how the changing balance between the influence of market and institutional factors has resulted in structural variation.

This chapter explores archetypal change in the context of professional service firms. To understand recent and ongoing changes in professional service firms, we briefly show how the professional archetype has evolved since the 1960s. We then present four theoretical models to describe processes by which institutionalized archetypes can change, and possibly coexist in the same field. Three professional archetypes are described, each in the context of historical development and the change model described earlier. At the one extreme is the traditional professional partnership; at the other the larger, multidisciplinary, corporate, global professional network, or GPN; in between is the “Star” form – relatively specialized, flatter structure, resisting significant growth, with fixations on excellence, and being the leader in a professional niche.

In this paper, we explore the effects of emerging digital technologies on professionalization within organizations. Specifically, we examine how the emergence of data analytics as a new cross-functional profession rooted in new digital technologies is challenging human resources (HR) as an established organizational profession. Our qualitative study reveals how rhetorical work and material work have established a symbiosis between data science and HR. Rather than leading to de-professionalization, new technologies are enabling HR practices to be augmented and new actors to be integrated into the professionalization project, thereby elevating the status of HR. These findings contribute to the literature on the role of technology in institutional theory and its influences on the professionalization.

Philip Selznick has been a central, historical figure in the development of institutional theory. In particular his contribution in TVA and the Grass Roots and Leadership in Administration has been key. However, we put forward the relevance of Selznick’s broader portfolio of ideas, to show that they could inform institutional analysis in new ways. There are important ideas and insights that can be brought to bear on contemporary issues within institutional theory. In particular, Selznick was concerned with the ways in which organizational goals are deflected because of different interest groups. Organizations use various kinds of cooptation to deal with interest groups. Selznick’s perspective implies that institutional theorists need to be concerned with both deflection of purposes and interests. These ideas are explored further in his work, The Organizational Weapon, showing a concern with the nefarious effects of organizational practices, an avenue that institutional theory needs to explore further. Indeed, Selznick was always concerned with the consequences of institutionalization. He dealt with issues of organizational governance, purposes and interests, ideas of unanticipated as well as anticipated consequences, negative as well as positive effects of institutionalization all of which require further analysis in contemporary institutional theory. Also at the heart of Selznick’s work was an emphasis on policy and practice, coming from American pragmatist philosophy. For Selznick, knowledge is to be utilized to produce good policy and practice. Institutional theorists need to consider the applications of their knowledge.

We bring together the institutional theory literature on institutional logics and the information systems (IS) literature that conceptualizes a relational view of affordances to explore the digital changes unfolding in the delivery of professional services. Through a qualitative inductive study of the development of an app led by a clinician manager in an Australian hospital, we investigate how multiple institutional logics shape the design of affordances when an organization develops new digital technologies for frontline professional work. Our findings show how a billing function was designed into the app by the development team over four episodes to afford potential physician users with billing usability, billing acceptability, billing authority and billing discretion. These affordances emerged as different elements of professional, state, managerial and market logics became activated, interpreted, evaluated, negotiated and designed into the digital technology through the team’s interactions with the clinician manager, a hybrid professional, during the app development process. Our findings contribute new insight to the affordance-based logics perspective by deepening understanding of the process through which multiple institutional logics play out in the design of affordances of digital technology. We also highlight the role of hybrid professionals in this digital transformation of frontline professional work.