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Article
Publication date: 31 August 2021

Christos Begkos and Katerina Antonopoulou

This study aims to investigate the hybridization practices that medical managers engage with to promote accounting and performance measurement in the hybrid setting of healthcare…

Abstract

Purpose

This study aims to investigate the hybridization practices that medical managers engage with to promote accounting and performance measurement in the hybrid setting of healthcare. In doing so, the authors explore how medical managers enact and become practitioners of hybridity.

Design/methodology/approach

The authors adopt a practice lens to conceptualize hybridization as an emergent, situated practice and capture the micro-activities that medical managers engage with when they enact hybridity. The authors conducted semi-structured interviews with medical managers, business managers and coding professionals and collected documents at an English National Health Service (NHS) hospital over the course of five years.

Findings

The findings accentuate two emergent practices through which medical managers instill hybridity to individuals who are hesitant or resistant to hybridization. Medical managers engage in equivocalizing and de-stigmatizing practices to broaden the understandings, further diversify or reconcile the teleologies of clinicians in non-managerial roles. In doing so, the authors signal the merits of accounting in improving care outcomes and remove the stigma associated to clinical engagement with costs.

Originality/value

The study contributes to hybridization and practice theory literature via capturing how hybridity is enacted in practice in a healthcare setting. As medical managers engage with and promote accounting information and performance measurement technologies in their practice environment, they transcend professional boundaries and hybridize the professional spaces that surround them.

Details

Accounting, Auditing & Accountability Journal, vol. 35 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 7 July 2014

Marco Sartirana, Anna Prenestini and Federico Lega

As a consequence of new public management reforms, leading professionals in public service organizations have increasingly been involved in management roles. The phenomenon of…

386

Abstract

Purpose

As a consequence of new public management reforms, leading professionals in public service organizations have increasingly been involved in management roles. The phenomenon of clinical directors in the healthcare sector is particularly representative of this, as this medical manager role has been adopted in many countries around the world. However, professionals’ managerial role taking still falls quite short of expectations. While most research has searched for the causes of this gap at the individual level by exploring the clash between management and professionalism, the purpose of the paper is to argue that a contextualized understanding of the antecedents at the organizational level, and particularly the existing medical management roles, provides a more thorough picture of the reality.

Design/methodology/approach

The paper adopts an institutional perspective to study the development of existing medical management roles and the rise of new ones (clinical directors). The analysis focuses on the case of Italy, a country with a tradition in medical management where, following the example of other countries, clinical director roles were introduced by law; yet they were not incisive. The paper is based on a review of the existing literature and extensive field research on Italian clinical directorates.

Findings

The paper shows how in contexts in which doctors in management roles exist and are provided with legitimacy deriving from legal norms, historical settlements between professions and taken for granted arrangements, medical management becomes institutionalized, stability prevails and change towards new doctor-in-management roles is seriously hampered.

Originality/value

The paper contributes to existing knowledge on professionals’ managerial role taking, underlining the relevance of contextual and nation-specific factors on this process. It provides implications for research and for policy making in healthcare and other professional public services.

Details

International Journal of Public Sector Management, vol. 27 no. 5
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 1 December 1998

Bie Nio Ong and Rita Schepers

The role of doctors in hospitals continues to change due to both external (policy) and internal (organisational change) pressures. Comparisons between The Netherlands and the UK…

Abstract

The role of doctors in hospitals continues to change due to both external (policy) and internal (organisational change) pressures. Comparisons between The Netherlands and the UK highlight that several models of medical management are formulated and exist alongside each other, leading to more flexibility in the roles of both doctors and managers. In particular, the agendas concerning the quality of clinical care and cost‐effectiveness are converging, emphasising the increasingly important role of medical managers.

Details

Journal of Management in Medicine, vol. 12 no. 6
Type: Research Article
ISSN: 0268-9235

Keywords

Article
Publication date: 7 July 2014

Kathy Hartley and Marcin Kautsch

The purpose of this paper is to present the findings of a short research project, conducted in 2010 as part of a larger EU funded action investigating the participation and impact…

477

Abstract

Purpose

The purpose of this paper is to present the findings of a short research project, conducted in 2010 as part of a larger EU funded action investigating the participation and impact of doctors in management. The authors sought to compare the ways in which hospital doctors in the UK and Poland – countries with distinct histories – participate in management; whether they are converging and whether the type of participation found results from changes in the governance and management of these systems.

Design/methodology/approach

First, a review of existing evidence and an analysis of policy documents and healthcare statistics were conducted. Identifying a lack of empirical data in the Polish context, and a potentially changing situation in the UK, the authors proceeded to collect some exploratory data in Poland, via interviews with expert informants, and to draw on data collected alongside this study in the UK from qualified doctors participating in research on management and leadership development.

Findings

Hospital doctors currently hold similar types of management role in both systems, but there are signs that change is underway. In Poland, different types of medical manager and role are now emerging, whereas in the UK younger doctors appear to be expecting greater management responsibility in the future, and are starting to take up the management training now on offer.

Research limitations/implications

The potential implications of these changes for the profession and policymakers in both Poland and the UK are discussed, with opportunities for further research highlighted.

Originality/value

The paper provides a comparison of how medical engagement within two systems with different histories is occurring, and also of the changes underway. It provides some much needed initial insight via interviews with expert informants within the polish system, which has been under-researched in relation to the involvement of medicine in management.

Details

International Journal of Public Sector Management, vol. 27 no. 5
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 1 October 1996

John Øvretveit

Notes that medical participation in organization‐wide quality programmes and leadership of quality is commonly viewed as the key to a successful programme. Reviews and reports…

524

Abstract

Notes that medical participation in organization‐wide quality programmes and leadership of quality is commonly viewed as the key to a successful programme. Reviews and reports research into doctors’ involvement in such programmes as distinct from doctors’ involvement in medical quality activities. Reveals the lack of systematic evidence on the subject, suggests areas for future research, and summarizes what is known. Gives recommendations based on reported research and experience for quality training for doctors and how medical managers might engage their colleagues and other professions in quality programmes.

Details

Journal of Management in Medicine, vol. 10 no. 5
Type: Research Article
ISSN: 0268-9235

Keywords

Content available

Abstract

Details

International Journal of Public Sector Management, vol. 27 no. 5
Type: Research Article
ISSN: 0951-3558

Abstract

Details

Developing and Engaging Clinical Leaders in the “New Normal” of Hospitals
Type: Book
ISBN: 978-1-80382-934-0

Abstract

Details

Health Management 2.0
Type: Book
ISBN: 978-1-80043-345-8

Article
Publication date: 27 March 2019

Jixia Mei and Ian Kirkpatrick

The purpose of this paper is to explore how far plans to “modernize” hospital management in China are converging toward a global model of new public management (NPM) or represent…

1213

Abstract

Purpose

The purpose of this paper is to explore how far plans to “modernize” hospital management in China are converging toward a global model of new public management (NPM) or represent a distinctive pathway.

Design/methodology/approach

This paper draws on a systematic review of available secondary sources published in English and Chinese to describe both the nature and trajectory of hospital management reforms in China.

Findings

In China, while public hospital reforms bear many of the hallmarks of the NPM, they are distinctive in two key respects. First, the thrust of current reforms is to partially reverse, not extend, the trend toward marketization in order to strengthen the public orientation of public hospitals. Second is a marked gap between the rhetoric and reality of empowering managers and freeing them from political control.

Practical implications

This paper develops a framework for understanding the drivers and obstacles to hospital management reforms in China that is useful for managers, clinicians and policy makers.

Originality/value

In China, few authors have considered NPM reform in relation to healthcare. This paper contributes in better understanding current reforms taking place in China’s expanding healthcare sector and locates these within broader theoretical and policy debates.

Details

International Journal of Public Sector Management, vol. 32 no. 4
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 1 April 1996

Stephen Horsley, Emilie Roberts, Diane Barwick, Steve Barrow and David Allen

Describes the results of a postal questionnaire survey of all 1,383 hospital consultants in the North Western Region of the UK in 1994; updating a similar survey conducted in…

489

Abstract

Describes the results of a postal questionnaire survey of all 1,383 hospital consultants in the North Western Region of the UK in 1994; updating a similar survey conducted in 1987. In both surveys, consultants were asked to describe their current management role, management training received and any perceived future training needs. A series of open questions in the 1994 survey explored barriers and incentives to the take‐up of management training. The results show that in 1994 more doctors were taking on greater management responsibility and from an earlier age. Consequently, the proportion of consultants expressing a need for management training had risen from 62 per cent in 1987 to 73 per cent in 1994. The most useful courses were local budgeting and business planning. However, many consultants described problems in accessing training. Concludes by highlighting policy implications arising from the surveys which will need to be addressed if consultants are to fulfil their management potential.

Details

Journal of Management in Medicine, vol. 10 no. 2
Type: Research Article
ISSN: 0268-9235

Keywords

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