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Book part
Publication date: 13 August 2012

Laurie Swinney and Bruce Elder

The accounting, medical, and legal professions share characteristics common to peer-reviewed professions. These professions also share challenges to professionalism. All…

Abstract

The accounting, medical, and legal professions share characteristics common to peer-reviewed professions. These professions also share challenges to professionalism. All three have been criticized for declining professionalism and for choosing commercial success over serving the public interest. Although the medical and legal professions have taken steps to promote a higher level of professional conduct by their members, the accounting profession has not launched initiatives to promote professionalism.

We discuss the initiatives instigated by the legal and medical professions using the five elements of professionalism framework (Hamilton, 2008a). Specifically, the framework highlights the importance of growth in personal conscience, demands compliance with the ethics of duty, inspires realization of aspirational goals, requires accountability of peer professionals, and emphasizes devotion to serving the public good. We recommend that members of the accounting profession use the five elements of professionalism framework to define, demonstrate, and assess professionalism. We conclude that promoting professionalism is a means for restoring professional identity for individual accountants as well as a means for fulfilling the accounting profession's contract with society.

Details

Research on Professional Responsibility and Ethics in Accounting
Type: Book
ISBN: 978-1-78052-761-1

Keywords

Article
Publication date: 26 October 2021

Florian Gebreiter

This paper examines the historical background of accountingization, colonization and hybridization in the health services by exploring the relationship between hospital…

Abstract

Purpose

This paper examines the historical background of accountingization, colonization and hybridization in the health services by exploring the relationship between hospital accounting and clinical medicine in Britain between the late 1960s and the early 2000s.

Design/methodology/approach

The paper draws on an analysis of professional journals, government reports and other documentary sources relating to accounting and medical developments. It is informed by Abbott's sociology of professions and Eyal's sociology of expertise.

Findings

The paper shows that not only accountants but also elements within the medical profession sought to make the practice of medicine more visible, calculable and standardized, and that accounting and medical attempts to make medicine calculable interacted in a mutually reinforcing manner. Consequently, it argues that a movement towards clinical forms of quantification within the medical profession made it more open to economic calculation, which underpinned hospital accounting reforms and the accountingization, colonization or hybridization of health services.

Originality/value

The paper demonstrates that a fuller understanding of the relationship between accounting and public sector professions can be developed if we examine their mutual interactions rather than restricting ourselves to analyzing accounting's effects on public sector professions. The paper moreover illustrates instances of intraprofessional conflict and inter-professional cooperation, and draws on the sociology of expertise to suggests that while hospital accounting reforms have curbed the power of medical professionals, they have also enhanced the power of clinical expertise.

Details

Accounting, Auditing & Accountability Journal, vol. 35 no. 5
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 20 June 2008

Karen Miller and Donna Clark

The paper aims to explore the increasing feminisation of the medical profession and career progression of women in the medical profession. Furthermore, the paper explores…

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Abstract

Purpose

The paper aims to explore the increasing feminisation of the medical profession and career progression of women in the medical profession. Furthermore, the paper explores the implications of gender segregation in the medical profession for health service provision.

Design/methodology/approach

The paper presents an overview of studies in this area and draws upon primary, empirical research with medical practitioners and medical students. However, unlike most other studies the sample includes male and female participants. The research involved élite interviews and self‐completion questionnaires in order to provide perspectives of both male and female medical practitioners and medical students.

Findings

The findings are consistent with those of other studies; that gender discrimination and segregation is still prevalent in the medical profession. But there are significant differences in perceptions between the genders. Moreover, it is concluded that the gendered career structure and organisational culture of the health sector and medical profession create a role conflict between personal and professional lives. The current difficulties in reconciling this role conflict create barriers to the career progression of women in the medical profession.

Research limitations/implications

Further research in this area could include a longitudinal study of medical students and the impact of changes in the design of medical training and career structures to assess whether these changes enable female career progression in the medical profession. Further analysis is needed of gendered practices and career development in specific specialist areas, and the role of the medical profession, NHS and Royal Colleges should play in addressing gender and career progression in medicine.

Practical implications

Gender segregation (vertical and horizontal) in the medical profession will have implications for the attraction, retention and increased shortages of practitioners in hospital and surgical specialities with the resultant economic and health provision inefficiencies.

Originality/value

The paper provides a review of literature in this area, thereby providing a longitudinal perspective of gender and the medical profession. Moreover, the research sample includes both male and female medical practitioners and medical students, which provides perspectives from both genders and from those who have experience within the medical profession and from those beginning their career in the medical profession. The research will be of value to the medical profession, the NHS and Royal Colleges of Medicine.

Details

Journal of Health Organization and Management, vol. 22 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Abstract

Details

Health Policy, Power and Politics: Sociological Insights
Type: Book
ISBN: 978-1-83909-394-4

Article
Publication date: 16 May 2016

Mia von Knorring, Kristina Alexanderson and Miriam A Eliasson

– The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

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Abstract

Purpose

The purpose of this paper is to explore how healthcare managers construct the manager role in relation to the medical profession in their organisations.

Design/methodology/approach

In total, 18 of Sweden’s 20 healthcare chief executive officers (CEOs) and 20 clinical department managers (CDMs) were interviewed about their views on management of physicians. Interviews were performed in the context of one aspect of healthcare management; i.e., management of physicians’ sickness certification practice. A discourse analysis approach was used for data analysis.

Findings

Few managers used a management-based discourse to construct the manager role. Instead, a profession-based discourse dominated and managers frequently used the attributes “physician” or “non-physician” to categorise themselves or other managers in their managerial roles. Some managers, both CEOs and CDMs, shifted between the management- and profession-based discourses, resulting in a kind of “yes, but […]” approach to management in the organisations. The dominating profession-based discourse served to reproduce the power and status of physicians within the organisation, thereby rendering the manager role weaker than the medical profession for both physician and non-physician managers.

Research limitations/implications

Further studies are needed to explore the impact of gender, managerial level, and basic profession on how managers construct the manager role in relation to physicians.

Practical implications

The results suggest that there is a need to address the organisational conditions for managers’ role taking in healthcare organisations.

Originality/value

Despite the general strengthening of the manager position in healthcare through political reforms during the last decades, this study shows that a profession-based discourse clearly dominated in how the managers constructed the manager role in relation to the medical profession on the workplace level in their organisations.

Details

Journal of Health Organization and Management, vol. 30 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 23 October 2003

Elianne Riska

The medicalization thesis derives from a classic theme in the field of medical sociology. It addresses the broader issue of the power of medicine – as a culture and as a…

Abstract

The medicalization thesis derives from a classic theme in the field of medical sociology. It addresses the broader issue of the power of medicine – as a culture and as a profession – to define and regulate social behavior. This issue was introduced into sociology 50 years ago by Talcott Parsons (1951) who suggested that medicine was a social institution that regulated the kind of deviance for which the individual was not held morally responsible and for which a medical diagnosis could be found. The agent of social control was the medical profession, an institutionalized structure in society that had been given the mandate to restore the health of the sick so that they could resume their expected role obligations. Inherent in this view of medicine was the functionalist perspective on the workings of society: the basic function of medicine was to maintain the established division of labor, a state that guaranteed the optimum working of society. For 20 years, the Parsonian interpretation of how medicine worked – including sick-role theory and the theory of the profession of medicine – dominated the bourgeoning field of medical sociology.

Details

Gender Perspectives on Health and Medicine
Type: Book
ISBN: 978-1-84950-239-9

Article
Publication date: 1 September 1997

Albert Caruana and Claire Carey

Many professionals abhor the thought of marketing their services. Marketing is assumed to be merely advertising and it is widely believed that advertising commercialises…

Abstract

Many professionals abhor the thought of marketing their services. Marketing is assumed to be merely advertising and it is widely believed that advertising commercialises and hence demeans professional services (Chan, 1992; Darling and Hackett, 1978). Although restrictions on advertising have been removed or relaxed in a number of countries, many professionals and their associations still regard advertising with suspicion and regulate its use. This is perhaps nowhere more so than with medical professionals. A fundamental rule set by medical professional associations in European and North American countries is that the doctor's job is not a business. More explicitly, the Medical Council in Luxembourg specifies that medicine cannot be exercised ‘as a business’. While it is perfectly acceptable for other professions to declare that profit is the enterprise's driving force, such a statement would go completely against the professional conscience of the medical profession. Medical practitioners are expected to observe a high ethical code. Respect for life should come before any other consideration. However, the medical professional's ability to survive depends as much on marketing as on his specialised technical skills. A different marketing approach from that used conventionally in the business sector may be needed, but the utility of marketing cannot be denied. Like businesspersons, medical practitioners also network with their market by being active within the community. These and other actions all contribute to make the individual a well‐known figure within the area of his practice (Gelb, Smith and Gelb, 1988). Medical practitioners in the various countries frequently belong to national medical professional associations. These often have legal standing, and are empowered to issue regulations and sanction non compliance on many aspects relating to the profession including advertising. This study first aims to position within a North American and European perspective the approach to advertising adopted by the Malta Medical Council. Secondly, it seeks to empirically investigate (1) the attitude of Maltese medical practitioners towards advertising by their profession, and (2) the attitude of the Maltese general public towards advertising by medical practitioners. In America, the general public have been found to have a more positive attitude towards advertising than medical practitioners and professionals in general (Darling and Hackett, 1978; Dyer and Shimp, 1980; Miller and Waller, 1979). Similarly, we expect that in Malta medical practitioners will exhibit a more negative attitude towards advertising than the general public.

Details

Management Research News, vol. 20 no. 9
Type: Research Article
ISSN: 0140-9174

Article
Publication date: 5 June 2007

Marie McHugh, Karen Johnston and Donna McClelland

The management of human resources is of crucial importance in enabling the delivery of efficient and effective services. The purpose of this paper is to explore one issue…

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Abstract

Purpose

The management of human resources is of crucial importance in enabling the delivery of efficient and effective services. The purpose of this paper is to explore one issue relevant to Human Resource Management, that is, the management of hospital doctors in the NHS. The present‐day UK National Health Service faces countless challenges at both the macro and operational level.

Design/methodology/approach

The paper examines the implications for the NHS in general, and the medical profession in particular, of the continued dominance of the medical profession over the career management of hospital doctors.

Findings

The paper argues that HRM must play a pivotal role in the management of clinicians to ensure the effective and efficient delivery of NHS reforms. The challenges to HRM and the medical profession that are inherent in this process are outlined.

Research implications/limitations

It is argued that the potential long‐term gains to be derived from the development of closer working relationships between human resource managers and medical managers are crucial for the delivery of an effective health service.

Originality/value

A new and innovative way of looking at the management of doctors and their careers within a changing NHS.

Details

International Journal of Public Sector Management, vol. 20 no. 4
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 15 October 2008

Sabine Hotho

The purpose of this paper is to extend the discussion of the recursive relationship between the identity of a profession and the professional identity of individuals in…

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Abstract

Purpose

The purpose of this paper is to extend the discussion of the recursive relationship between the identity of a profession and the professional identity of individuals in the context of change.

Design/methodology/approach

The paper draws on qualitative data collected as part of a pilot study into change in the NHS. It draws on structuration theory and insights from social identity theory (SIT) to propose that the relationship between the collective level of the profession and the individual level of the professional is recursive.

Findings

The data suggest that individual professionals use and rewrite scripts of their profession but also draw upon new scripts as they engage with local change. To that extent they contribute from the local level upwards to the changing identity of their profession. Further more detailed micro level studies are required.

Research limitations/implications

The argument is based on a limited data set and points towards the need for further microlevel studies which examine the recursive relationship between professionals' identity and the identity of a profession.

Practical implications

Further research can contribute to better understanding of local variance as professionals engage with change.

Originality/value

The paper fuses structuration theory and SIT and examines the agency/structure nexus in a specific change context.

Details

Journal of Organizational Change Management, vol. 21 no. 6
Type: Research Article
ISSN: 0953-4814

Keywords

Book part
Publication date: 30 August 2019

Jennifer McDonald and Claudia Chaufan

To shed light on how gender norms are reproduced in medical training and practice through an exploration of representations of the problem of “work–life balance.” Women…

Abstract

Purpose

To shed light on how gender norms are reproduced in medical training and practice through an exploration of representations of the problem of “work–life balance.” Women physicians and women physician-researchers (WPs/WPRs) in Canada and in the United States experience social and health inequities when compared to their men colleagues. Despite current medical school acceptance parity, upon entering the medical workforce, women work harder than men to succeed within the historically male-dominated structures and value system of the medical profession.

Methodology

We performed a critical discourse analysis of articles retrieved from academic databases and leading Anglo-American journals that discussed “work–life balance,” to investigate how the discourse contributed to, or challenged, the reproduction of gender norms in medicine.

Findings

While the medical literature acknowledges that the social and health inequities experienced by WP/WPR result from discriminatory norms and practices, it neglects to challenge built-in gendered inequities in benchmarks for success in the profession. Instead, proposed solutions require that WP/WPR themselves learn to cope and make better lifestyle choices, including downloading domestic responsibilities on socially disadvantaged – racialized and poor – women. Authors’ gender appears to make no difference.

Research Limitations

Our search was limited to the Anglo-American literature, often retrieved articles inaccessible via our university library, excluded informal venues (e.g., blogs), and did not include cases of same-sex couples or interviews of WP/WPR. All these may have challenged components of our argument by revealing more nuanced debates, occurring under different political, cultural, and economic contexts.

Policy Implications

While individual choices of WP/WPR are important to the protagonists, to successfully address the very real problem of work–life balance experienced by WP/WPR, patriarchal norms should be challenged, failure to comply with these norms should be rejected as explanations for work–life balance challenges, and norms themselves should become the focus of analysis and intervention.

Originality/Value

The medical language used by physicians of both genders normalizes gendered inequities, favoring the success of medical men over women, and reproducing the professional and personal disadvantages experienced by the latter, further burdening socially disadvantaged women.

Details

Underserved and Socially Disadvantaged Groups and Linkages with Health and Health Care Differentials
Type: Book
ISBN: 978-1-83867-055-9

Keywords

1 – 10 of over 14000