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This study aims, first, to explore and analyze if and how organizational members’ professions or occupations influence perceptions of internal crisis communication. The second, related, aim is to discuss the role of internal communication in creating a strong organizational identity during a prolonged crisis such as the Covid-19 pandemic.

This study is mainly conceptual but uses quantitative data from a survey conducted in a health-care organization in late 2020 to illustrate the theoretical reasoning.

The results show that the administrative groups perceive factors in the internal crisis communication more favorably than the professional groups. The study suggests that organizational members perceive internal crisis communication differently depending on which intra-organizational group they belong to. This further points to the absence of a “rally-around-the-flag” effect and highlights the importance of working proactively with professionals and in internal crisis communication.

This study highlights the role of professionals in crisis communication, which is an aspect that so far has been ignored. The internal professionalization processes and an intriguing power struggle between professions have obvious consequences for crisis communication. As shown in the overview of earlier research on internal communication, leadership and professional organizations, the prerequisites for creating an increased organizational unity among coworkers are challenging. The idea that a crisis may, as in certain political situations in society, create a “rally-around-the-flag” effect is still relevant, even if the case study is an example of how this did not happen.

The paper aims to analyse the meaning and extension of discretionary power of social service professionals within network-based interventions.

Empirically, the paper is based on a case study of a network-based policy involving private and public organisations in the Northeast of Italy (Province of Trento).

The paper identifies netocracy as a social policy logic distinct from bureaucracy and professionalism. What legitimises netocracy is neither authority nor expertise but cooperation, the activation of connections and involvement, considered “good” per se. In this framework, professionalism and discretion acquire new and problematic meanings compared to street-level bureaucracy processes.

Based on a case study, the research results cannot be generalised but pave the way to further comparative investigations.

The paper reveals that the position of professionals in netocracy is to some extent trickier than that in a bureaucracy because netocracy seems to have the power to encapsulate them and make it less likely for them to deviate from expected courses of action.

Combining different literature streams – street level bureaucracy, professionalism, network organisations and welfare governance – and building on an original case study, the paper contribute to understanding professionalism in welfare contexts increasingly characterised by the combination of bureaucratic, professional and network logics.

The healthcare sector is experiencing a major paradigm shift toward a people-centered approach. The key issue with transitioning to a people-centered approach is a lack of understanding of the ever-increasing role of technology in blended human-technology healthcare interactions and the impacts on healthcare actors' well-being. The purpose of the paper is to identify the key mechanisms and influencing factors through which blended service realities affect engaged actors' well-being in a healthcare context.

This conceptual paper takes a human-centric perspective and a value co-creation lens and uses theory synthesis and adaptation to investigate blended human-technology service realities in healthcare services.

The authors conceptualize three blended human-technology service realities – human-dominant, balanced and technology-dominant – and identify two key mechanisms – shared control and emotional-social and cognitive complexity – and three influencing factors – meaningful human-technology experiences, agency and DART (dialogue, access, risk, transparency) – that affect the well-being outcome of engaged actors in these blended human-technology service realities.

Managerially, the framework provides a useful tool for the design and management of blended human-technology realities. The paper explains how healthcare services should pay attention to management and interventions of different services realities and their impact on engaged actors. Blended human-technology reality examples – telehealth, virtual reality (VR) and service robots in healthcare – are used to support and contextualize the study’s conceptual work. A future research agenda is provided.

This study contributes to service literature by developing a new conceptual framework that underpins the mechanisms and factors that influence the relationships between blended human-technology service realities and engaged actors' well-being.

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their day-to-day work. Professionals’ discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally.

The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran’s administration hospital/clinic in the Northeastern USA. Interview responses were qualitatively coded for themes and patterns across groups were identified.

The health care providers and the authors studied actively sought to uphold the protection (and control) of patient information through professional ethics and practices, as well as through the use of technologies and compliance with legal regulations. They used discourses of professionalism, as well as of law and technology, to sometimes accept and sometimes resist changes to practice required in the changing technological and legal context of health care. The authors found differences across professional groups; for some, protection of patient information is part of core professional ethics, while for others it is simply part of their occupational work, aligned with organizational interests.

This qualitative study of physicians, nurses, and health information professionals revealed some differences in views and practices for protecting patient information in the changing technological and legal context of health care that suggest some professional groups (doctors) may be more likely to resist such changes and others (health information professionals) will actively adopt them.

New technologies and regulations are changing how information is used in health care delivery, challenging professional practices for the control of patient information that may change the value or meaning of medical records for different professional groups.

Qualitative findings suggest that professional groups in health care vary in the extent of information control they have, as well in how they view such control. Some groups may be more likely to (be able to) resist changes in the professional control of information that stem from new technologies or regulatory policies. Some professionals recognize that new IT systems and regulations challenge existing social control of information in health care, with the potential to undermine (or possibly bolster) professional self-control for some but not necessarily all occupational groups.

This study seeks to improve the understanding of physician leaders' leadership work challenges.

The subjects of the empirical study were physician leaders (n = 23) in the largest central hospital in Finland.

A total of five largely identity-related, partially paradoxical dilemmas appeared regarding why working as “just a leader” is challenging for physician leaders. First, the dilemma of identity ambiguity between being a physician and a leader. Second, the dilemma of balancing the expected commitment to clinical patient work by various stakeholders and that of physician leadership work. Third, the dilemma of being able to compensate for leadership skill shortcomings by excelling in clinical skills, encouraging physician leaders to commit to patient work. Fourth, the dilemma of “medic discourse”, that is, downplaying leadership work as “non-patient work”, making it inferior to patient work. Fifth, the dilemma of a perceived ethical obligation to commit to patient work even if the physician leadership work would be a full-time job. The first two issues support the findings of earlier research, while the remaining three emerging from the authors’ analysis are novel.

The authors list some of the practical implications that follow from this study and which could help solve some of the challenges.

This study explores physician leaders' leadership work challenges using authentic physician leader data in a context where no prior empirical research has been carried out.

Recent literature within public service logic has called for more explicit conceptualisation of customer value in public services. This study aims to fill this gap by examining how the customer value approach can be applied in the management of public health care services.

This study is a qualitative case study of management of public health care services in Finland. The authors interviewed 17 regional health care service developers and analyzed the interview data using thematic analysis.

The study suggests five propositions for applying customer value approach from the marketing literature in public health care service management. The study enables a deeper understanding of customer value creation in this context and improvement of public health care services.

This study contributes to the public management research in general and public service logic research in particular by suggesting what constitutes customer value in public health care services.

The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.

Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.

The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system). This evolution in thinking about wrongdoing is also visible in public inquiries, as analysis and recommendations increasingly tend to emphasise cultural and systematic issues. Yet, while organisational and systemic factors are undoubtedly important, there is a need to keep in sight the role of individuals, for two key reasons. First, there is growing evidence that a small number of doctors may be disproportionately responsible for large numbers of complaints and concerns. Second, there is a risk that the role of individual professionals in drawing attention to wrongdoing is being neglected.

To the best of the authors’ knowledge this is the first theoretical and empirical study specifically exploring the role of NHS inquiries in holding the medical profession to account for failings in professional practice.

The purpose of this paper is to analyze how “New Deal” regulatory initiatives, primarily the Securities Acts and the Securities and Exchange Commission (SEC), changed US auditors’ professional knowledge conception, culminating in the 1938 expansion of the Committee on Accounting Procedure (CAP), the first US body to set accounting principles.

The paper combines Halliday’s (1985) knowledge mandates with Hancher and Moran’s (1989) regulatory space to attain a theory-based understanding of auditors’ changing knowledge conceptions amid regulatory pressure. It draws on a range of primary and secondary sources to examine the period from 1929 to 1938.

Following the stock market crash, the newly created SEC aimed to engage auditors as a means to regulate companies’ accounting practices based on a set of codified principles. While entailing increased status, this new role conflicted with the auditors’ knowledge conception, which was based on professional judgment and personal integrity. Pressure from the SEC and academics eventually made auditors agree to a codification of their professional knowledge and create the CAP as a cooperative regulatory solution.

The paper explores the role of auditors’ knowledge conceptions in the emergence of today’s standard setting. It is suggested that auditors’ incomplete control of their professional knowledge made standard setting a form of co-regulation, located between the actors occupying the regulatory space of accounting.