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Article

Stinne Glasdam and Jeppe Oute

The purpose of this paper is to explore how, and under what conditions, professionals involve relatives in clinical practice.

Abstract

Purpose

The purpose of this paper is to explore how, and under what conditions, professionals involve relatives in clinical practice.

Design/methodology/approach

Two cases were constructed from two studies in Denmark, theoretically inspired by Bourdieu’s concepts of doxa and position and analyzed with focus on the involvement of relatives from the perspective of professionals.

Findings

Support to relatives in practice is rarely included in the way that treatment and care are organized in healthcare. Professionals’ views of the involvement of relatives were characterized by the values of neoliberal ideology and medical-professional rationality, in which relatives are not regarded as a subject of care and support in clinical practice. The involvement of relatives aimed to ensure patients’ participation in randomized clinical trial and to help professionals to care for patients when the professionals were not absolutely needed. Professionals were relatively higher positioned in the clinic than relatives were, which allowed professionals to in – and exclude relatives. Neoliberal ideology and medical-professional rationality go hand in hand when it comes to patient treatment, care and the involvement of relatives; it is all about efficiency, treatment optimization and increased social control of the diagnosed patient. These neoliberal, organizational values consolidate doxa of the medical field and the positions that govern the meeting with patients’ relatives – if it takes place at all.

Originality/value

The results put into perspective how the combination of neoliberalism and medical logic work as an organizing principle in contemporary healthcare systems, and challenge a normative, humanistic view on involving patients’ relatives in the medical clinic.

Details

Journal of Organizational Ethnography, vol. 8 no. 2
Type: Research Article
ISSN: 2046-6749

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Article

Richard S. Bolan

This paper is concerned with enlarging the traditional view of rationality that has dominated management and planning in modern times. The inquiry begins by re‐examining…

Abstract

This paper is concerned with enlarging the traditional view of rationality that has dominated management and planning in modern times. The inquiry begins by re‐examining Weber’s discussion of rationality as interpreted by contemporary analysts. Weber saw rationality as multi‐faceted and included notions of a social rationality involving more than simple instrumental or “practical” rationality. Habermas’ ideas concerning communicative action are then introduced as the basis for parsing out Weber’s differing conceptions of rationality based on the dual underlying motivations of pursuing social agreement along with technical or instrumental goals. In dialectical fashion, the paper introduces the concept of adaptive rationality involving a synthetic form of reason that mediates between substantive, or social, rationality and instrumental, or technical, rationality. This adaptive form of reason is seen as the heart of management and planning and requires a combined technical, political and moral imagination in the service of creating new forms of social practice and marshaling both the collective will and resources for their fulfillment. Thus, the paper argues for a wider conception of rationality that explicitly acknowledges social norms and the distribution of power and concludes with the hope of a renewed focus of research for a richer understanding of rational action.

Details

Journal of Management History, vol. 5 no. 2
Type: Research Article
ISSN: 1355-252X

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Book part

Kevin Olson

This essay investigates the meaning of rationality in Michel Foucault's notion of “governmental rationality,” both in what he takes rationalities to be and in how they…

Abstract

This essay investigates the meaning of rationality in Michel Foucault's notion of “governmental rationality,” both in what he takes rationalities to be and in how they relate to practices of governing. I try to resolve these questions in a sympathetic manner by detailing some of the social dynamics implicit in practices of governing. Pierre Bourdieu provides means to connect such practices with a detailed understanding of social struggle and resistance to power. These insights reveal strong lines of continuity between governmental rationality and collective political resistance to it. On this basis, I suggest a new path of investigation into forms of popular sovereignty as relatively neglected examples of governmental rationality.

Details

No Social Science without Critical Theory
Type: Book
ISBN: 978-1-84950-538-3

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Article

Lili Yin, Lizhong Duan, Yinran Zhang, Hangyu Liu, Chongxu Zhang, Qiaoqiao Sun and Qi Lu

Through a questionnaire survey, the purpose of this paper is to understand and analyse the cognitions of medical service price of medical workers in various regions of…

Abstract

Purpose

Through a questionnaire survey, the purpose of this paper is to understand and analyse the cognitions of medical service price of medical workers in various regions of China, and discuss the policy suggestions on the price dynamic adjustment of medical service.

Design/methodology/approach

The authors conducted a questionnaire survey on the cognition of medical service price medical workers in various regions of China, and then the grey relational analysis theory is used to analyse the data obtained from the questionnaire survey.

Findings

The investigation and analysis shows some cognitions of hospital workers on the price of medical services in various regions in China, the authors analyse the results of grey relational analysis and come up with suggestions for relevant departments.

Research limitations/implications

Although a plenty of research on the current situation of medical service price cognition of China is discussed in the paper, it is not complete; thus, a large amount of information needs to be consulted further. The data obtained from the questionnaire are less used and the utilisation rate is lower, which may result in one-sided results and need further investigation.

Practical implications

Through the investigation and analysis, the authors can determine about the implementation of medical service prices in various parts of China from the perspective of hospital workers to a certain degree, and try to explore the relevant policy recommendations for the dynamic adjustment of medical service prices.

Social implications

The price of medical services refers to the fees for registration, diagnosis, inspection, surgery, nursing and medicine. In a narrow sense, the price of medical services refers to the standard of charge for medical services except drugs. This paper mainly refers to the narrow sense. As one of the important means and methods for the government to control the medical service market, medical service price is also an important basis for the economic source of medical institutions. The adjustment of medical service price is related to the interests of all aspects of society.

Originality/value

Medical service price is an important basis for the economic source of medical institutions, the adjustment of medical service price is related to the interests of all aspects of society and it is a hot issue of social concern. Through the investigation and analysis, the authors use grey relational analysis to know about the medical service prices in various parts of China from the perspective of hospital workers to a certain degree, and try to explore the relevant policy recommendations for the dynamic adjustment of medical service prices.

Details

Grey Systems: Theory and Application, vol. 9 no. 2
Type: Research Article
ISSN: 2043-9377

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Article

Janice McLaughlin

This paper examines the role of various boundaries in giving both professional groups and individuals a sense of identity that provides both with status and legitimacy…

Abstract

This paper examines the role of various boundaries in giving both professional groups and individuals a sense of identity that provides both with status and legitimacy. Close attention is paid to the boundaries between personal and professional identities and values. Sociologists working with a discursive approach argue that professional identity and status are achieved through the rhetorical presentation of certain values and responsibilities as personal, and therefore outside the boundaries of professional practice. This paper takes this argument forward, by arguing that in particular contexts, certain kinds of values are consciously articulated as personal and incorporated into the defence of professional legitimacy. Bringing personal claims inside professional boundaries is further evidence of the fluid and negotiated quality of the boundary between personal and professional values and notions of self. The paper consists of a discussion of the construction of professional boundaries, professional involvement in risk, issues raised by antenatal screening and analysis of a study of a group of professionals involved in antenatal screening. The paper explores the circumstances within which even senior professional groups and individuals look to representations of the personal self as a defence against critiques of their professional practice. Where the risks that professionals generate and interpret are medically ambiguous and socially contentious the abstract professional and medical framework is insufficient and other rhetorical values become resources in securing the professional role.

Details

Journal of Health Organization and Management, vol. 17 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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Book part

Terry Gibson

Abstract

Details

Making Aid Agencies Work
Type: Book
ISBN: 978-1-78769-509-2

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Article

Joseph Dumit

Using as an example the mental health mass screening and treatment programmes instituted in some US states, Joseph Dumit describes how the western world has arrived at a…

Abstract

Using as an example the mental health mass screening and treatment programmes instituted in some US states, Joseph Dumit describes how the western world has arrived at a state of ‘dependent normality’ in which being diagnosed and dependent on medication is rendered ordinary, largely through the marketing activities of the pharmaceutical industry, which seeks constantly to expand its market by defining at‐risk populations as broadly as possible, and through persuading the public that all risks must be combated with drugs.

Details

Journal of Public Mental Health, vol. 4 no. 3
Type: Research Article
ISSN: 1746-5729

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Article

Maria Major, Ana Conceição and Stewart Clegg

The purpose of this paper is to demonstrate the role of power relations in initiating and blocking accounting change that involves increased “responsibilisation” and…

Abstract

Purpose

The purpose of this paper is to demonstrate the role of power relations in initiating and blocking accounting change that involves increased “responsibilisation” and “incentivisation”, and to understand how institutional entrepreneurship is steered by power strategies.

Design/methodology/approach

An in-depth case study was carried out between 2010 and 2015 in a cardiothoracic surgery service (CSS) where a responsibility centre was introduced.

Findings

Introducing a responsibility centre within a CSS led to a change process, despite pressures for stability. The institutionalisation of change was conditioned by entrepreneurship that flowed through three circuits of power. Strategies were adapted according to changes in exogenous environmental contingencies and alterations in the actors’ relationships.

Originality/value

The contributions of the paper are several: first, it demonstrates that the existing literature discussing the implementation of responsibility centres cannot be isolated from power issues; second, it expands understanding of the power dynamics and processes of institutional entrepreneurship when implementing accounting change; third, it shows how change introduced by exogenous political economic events structured organisational circuits of power and blocked the introduction of the change initiative.

Details

Accounting, Auditing & Accountability Journal, vol. 31 no. 4
Type: Research Article
ISSN: 0951-3574

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Article

S. Lawrence, M. Alam, D. Northcott and T. Lowe

Studies the transformation of social systems in health organizations in New Zealand and the way in which accounting systems are an integral part of the challenge to extant…

Abstract

Studies the transformation of social systems in health organizations in New Zealand and the way in which accounting systems are an integral part of the challenge to extant structures of signification, legitimation and domination. By categorizing various modes or types of social change, and providing analytical means of clarifying social systems, Giddens’s structuration theory is enabling of empirical study. Accounting systems contribute to the binding of time and space in some circumstances, yet can play a part in major discontinuities and disruptions to institutionalized procedures and practices in other circumstances.

Details

Accounting, Auditing & Accountability Journal, vol. 10 no. 5
Type: Research Article
ISSN: 0951-3574

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Article

Agneta Ranerup

The relationship between the state and the individual is, more than ever before, being mediated by public portals. The requirement specifications for public portals can be…

Abstract

Purpose

The relationship between the state and the individual is, more than ever before, being mediated by public portals. The requirement specifications for public portals can be said to define the level of expectation among influential actors concerning the roles of the individual in this relationship at a certain point in time. At the same time, they are part of an emergent‐development process. The purpose of this paper is to test this perspective in the empirical context of healthcare.

Design/methodology/approach

This research proposes a framework for analysing the requirement specifications for public portals, making various roles possible, such as being a patient, a citizen, a consumer, and a customer. The framework is tested in a case study of a Swedish national healthcare portal.

Findings

It can be concluded that prominent actors in this particular context of design defined the requirement specification so that the patient and citizen roles were well supported, whereas the roles of the consumer and customer were supported in a less well‐developed manner. The case study also indicated the importance of reusing already existing functionality to attain quick and tangible results. Consequently, the individual is both enhanced and limited by the “travel of ideas” in the form of the reuse of existing functionality.

Originality/value

This paper puts forward the view that the requirement specifications for public portals are part of the emergent formation of an e‐governance relationship.

Details

Transforming Government: People, Process and Policy, vol. 5 no. 2
Type: Research Article
ISSN: 1750-6166

Keywords

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