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The purpose of this study is to examine the rostering practices and work experiences of medical scientists at four health services in the Australian public healthcare sector. There are over 16,000 medical scientists (AIHW, 2019) in Australia responsible for carrying out pathology testing to help save the lives of thousands of patients every day. However, there are systemic shortages of medical scientists largely due to erratic rostering practices and workload issues. The purpose of this paper is to integrate evidence-based human resource management (EBHRM), the LAMP model and HR analytics to enhance line manager decision-making on rostering to support the wellbeing of medical scientists.

Using a qualitative methodological approach, the authors conducted 21 semi-structured interviews with managers/directors and nine focus groups with 53 medical scientists, making a total 74 participants from four large public hospitals in Australia.

Across four health services, manual systems of rostering and management decisions do not meet the requirements of the enterprise agreement (EA) and impact negatively on the wellbeing of medical scientists in pathology services. The authors found no evidence of the systematic approach of the organisations and line managers to implement the LAMP model to understand the root causes of rostering challenges and negative impact on employees. Moreover, there was no evidence of sophisticated use of HR analytics or EBHRM to support line managers' decision-making regarding mitigation of rostering related challenges such as absenteeism and employee turnover.

The authors contribute to HRM theory by integrating EBHRM, the LAMP model (Boudreau and Ramstad, 2007) and HR analytics to inform line management decision-making. The authors advance understandings of how EBHRM incorporating the LAMP model and HR analytics can provide a systematic and robust process for line managers to make informed decisions underpinned by data.

This article is drawn from doctoral research exploring the identity struggles faced by professionals who take on management and leadership roles. The research focused on the experience of medical directors – the most senior doctor‐manager with board responsibility for medical affairs. Based on the fact that a medical director is a hybrid manager this research has implications for any professional who takes on a managerial or leadership role while continuing to practice their profession. Some challenges of working as a hybrid are associated with the difference in orientations between professionals and managers. While the notion of who and what a professional is has changed and new forms of accommodation have been forged the hybrid identity remains a site of potential conflict for the individual and those they work with. The purpose of this paper is to explore the experience of the hybrid identity.

The experience of the hybrid identity is explored through social identity theory (Tajfel and Turner).

The analysis reveals that the medical director role is ambiguous, that medical identity is robust and that medical management is difficult compared to clinical work. Managerial identity in general is constructed negatively and from the perspective of doctors. The importance of maintaining clinical credibility is both embraced as a resource which bolsters and maintains medical identity and so distinguishes medical directors from the taint associated with the pejorative managerial identity that doctors construct of managers.

The implications for the selection, training and development of doctors and medical directors are raised as are those for the relationship between doctors and patients, and doctors and the organisation. Some implications identified, specifically for leadership in practice are as follows: leadership/management is challenging and difficult compared to professional work; language use is significant for how leaders are perceived; language use has implications for leader effectiveness; early exposure to leadership for professionals is important; and leadership role definition is important for consistency and role credibility.

The purpose of this article is to describe and analyse the identity challenges that physicians with medical leadership positions face.

Four qualitative case studies were performed to address the fact that identity is processual, relational and situational. Physicians with managerial roles were interviewed, as well as their peers, supervisors and subordinates. Furthermore, observations were made to understand how different identities are displayed in action.

This study illustrates that medical leadership implies identity struggles when physicians have manager positions, because of the different characteristics of the social identities of managers and physicians. Major differences are related between physicians as autonomous individuals in a system and managers as subordinates to the organizational system. There are psychological mechanisms that evoke the physician identity more often than the managerial identity among physicians who are managers, which explains why physicians who are managers tend to remain foremost physicians.

The implications of the findings, that there are major identity challenges by being both a physician and manager, suggest that managerial physicians might not be the best prerequisite for medical leadership, but instead, cooperative relationships between physicians and non-physician managers might be a less difficult way to support medical leadership.

Acknowledging and addressing identity challenges can be important both in creating structures in organizations and designing the training for managers in healthcare (both physicians and non-physicians) to support medical leadership.

Medical leadership is most often related to organizational structure and/or leadership skills, but this paper discusses identity requirements and challenges related to medical leadership.

The purpose of this paper is to explore the dual role of physician-managers through an examination of perceptions of trust and distrust in physician-managers. The healthcare sector needs physicians to lead. Physicians in part-time managerial positions who continue their medical practice are called part-time physician-managers. This paper explores this dual role through an examination of perceptions of trust and distrust in physician-managers.

The study takes a qualitative research approach in which interviews and focus group discussions with physician-managers and nurse-managers provide the empirical data. An analytical model, with the three elements of ability, benevolence and integrity, was used in the analysis of trust and distrust in physician-managers.

The respondents (physician-managers and nurse-managers) perceived both an increase and a decrease in physicians’ trust in the physician-managers. Because elements of distrust were more numerous and more severe than elements of trust, the physician-managers received negative perceptions of their role.

This paper’s findings are based on perceptions of perceptions. The physicians were not interviewed on their trust and distrust of physician-managers.

The healthcare sector must pay attention to the diverse expectations of the physician-manager role that is based on both managerial and medical logics. Hospital management should provide proper support to physician-managers in their dual role to ensure their willingness to continue to assume managerial responsibilities.

The paper takes an original approach in its research into the dual role of physician-managers who work under two conflicting logics: the medical logic and the managerial logic. The focus on perceived trust and distrust in physician-managers is a new perspective on this complicated role.

The perpose of this paper is to analyse recent changes in the management of French public hospitals, following a reform enacted in 2009 and aimed at bolstering the managerial roles of doctors.

The paper is exploratory and is based on both the analysis of French literature dealing with the results of the 2009 reform, and ten semi-directed interviews with clinical managers and top leaders in the public hospital sector.

The author reports on the major hospital management reforms of 2009 and analyse the implications for the medical profession and management. The author shows that the involvement of the classical clinical leaders has become less regulated as the units no longer have a clear legal basis. The governance of the newly introduced “medical poles” appears to be shaped by various factors: there is high correlation between centrality, prestige and “clan involvement”, which suggests that professionals holding new responsibilities obtain power and legitimacy by consolidating pre-existing networks. While it is often argued that high-quality clinical leadership is a key factor of organisational success, the findings suggest that the performance of clinical managers relies on this network and legitimacy acquired from it.

Drawing on the “sociology of translation” and actor-network theory (Callon and Latour, 1991), this paper provides a new conceptual framework for the analysis of the transformation of the role of clinical leaders, arguing that this transformation depends highly on their abilities to build and use networks. The findings challenge the French tradition of public management that presupposes a clear division of power between doctors and administrative staff.

Reports the results of a survey of 209 senior registrars and 269 consultants throughout Wales to identify the management development needs of doctors and ascertain their views of the value and utility of current management development course offerings in Wales. Finds that, currently, management development for doctors in Wales is unstructured and unco‐ordinated but, despite this, many doctors, especially senior registrars, appeared keen to increase their future involvement in management and held positive views regarding management and management development. The questionnaire also required doctors to rank order six managerial topics and their elements: financial, human resource, strategic, operational, service quality and self‐management. Of these, self‐management issues were rated highest and there was some congruity in the rankings of the six topics by senior registrars and the other three consultant categories. Overall, managing a budget, medical and clinical audit, negotiating skills and leadership skills were ranked highest for inclusion in management development while project management, quality circles and equal opportunities received the lowest ratings.

Purpose – In the last decades, Italian healthcare organisations have been subject to important normative changes, aimed at increasing their efficiency. As a response, performance measurement and evaluation (PME) systems have been introduced. The present study attempts to examine PME system changes as institutional processes. In studying such processes the healthcare literature acknowledges the presence of two logics: managerial and professional, as peculiar to healthcare settings, whose convergence or divergence can explain the success of any institutional process.

Design/methodology/approach – We adopt Busco et al.'s (2007) framework as an approach for unbundling PME system change into four relevant coordinates, namely: (1) the object (PME system), (2) the subjects (institutional forces), (3) the place and time of change (the managerial and professional logics) and (4) the how and why change happens (change as an institutional process). We conducted a longitudinal case study at a large teaching hospital in Southern Italy, directed to interpret PME system changes during the period from 1998 until 2009.

Findings – Our observation distinguishes episodes of successful institutional processes, where the introduced innovations are transformed into objectivated practices, from episodes of missed institutionalisation, where new procedures were rapidly abandoned.

Research and social implications – This theoretical framework can be useful for interpreting the PME system changes in different institutional contexts.

Originality – The Busco et al.'s framework allows us to understand PME system changes by integrating the perspectives from Neo-Institutional Sociology, representing healthcare organisational responses to external institutional pressures, and Old-Institutional Economics, conceptualising PME system changes as an institutionalisation process.

This paper examines medical managers' beliefs about the impact reduced‐hour career paths for physicians has on organizational effectiveness. The findings of this exploratory inductive study of 17 medical managers at nine medical organizations in the Boston area suggest that managers believe the benefits of reduced‐hour physicians (RHPs) far outweigh the disadvantages. However, many of their reasons appear to be exploitative of RHPs. In particular, managers believe that employing RHPs results in increased managerial control and that RHPs should: work more than they are compensated for; do a disproportionate share of the undesirable work; and remain extra flexible and available to the organization. An interpretation of the findings based on psychological contract theory is offered, and may help to illuminate other results reported in the literature, including some controversial findings that reduced‐hour workers tend to have poor health outcomes.

Analyses the way hospital organisation models handle the relationship between medical specialists and hospital management. All models that have been developed during the last ten years seek to integrate the medical specialists in the hospital organisation by formally subordinating them to the hospital management. However, recently a new model has come to the fore ‐ the “co‐makership” ‐ in which the hospital management and the medical specialists are assigned a position alongside each other.

The purpose of this paper is to explore issues of medical engagement in the management and leadership of health services in the English National Health Service (NHS). The literature suggests that this is an important component of high performing health systems, although the NHS has traditionally struggled to engage doctors and has been characterised as a professional bureaucracy. This study explored the ways in which health care organisations structure and operate medical leadership processes to assess the degree to which professional bureaucracies still exist in the English NHS.

Drawing on the qualitative component of a research into medical leadership in nine case study sites, this paper reports on findings from over 150 interviews with doctors, general managers and nurses. In doing so, the authors focus specifically on the operation of medical leadership in nine different NHS hospitals.

Concerted attention has been focussed on medical leadership and this has led to significant changes to organisational structures and the recruitment and training processes of doctors for leadership roles. There is a cadre of doctors that are substantially more engaged in the leadership of their organisations than previous research has found. Yet, this engagement has tended to only involve a small section of the overall medical workforce in practice, raising questions about the nature of medical engagement more broadly.

There are only a limited number of studies that have sought to explore issues of medical leadership on this scale in the English context. This represents the first significant study of this kind in over a decade.