The paper identifies that primary-care clinical-management roles focus on operational management and oversight and discusses the structural and role-related factors which affect their efficacy.

This paper explores how general practitioners (GPs) address potentially opposing motivations stemming from being altruistic and self-interested, and the implications for patients and GPs. The author finds that GPs address dual goals of patient care and profit generation. This can be challenging, while professional values (altruism) encourage a patient focus, business realities (self-interest) mandate other priorities. Viewing clinicians as altruistic in isolation of business needs is unrealistic, as is the notion that profit is the dominant motivation. A blending of interests occurs, pursuing reasonable self-interest, patients’ best interests are ultimately met. GPs need a profit focus to sustain/improve the practice, benefitting patients through continued availability and capacity for enhancement. Therefore, it is argued that GPs behave in a manner that is ‘part altruistic, part self-interested’ and mutually beneficial. These insights should be considered in designing incentive systems for GPs, raising compelling questions about contemporary understanding of the nature of professionals.

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Purpose – The purpose of this paper is to focus on the other end of entrepreneurship – the disassembling of enterprises by insolvency professionals. Design/methodology/approach – Drawing on empirical material from major insolvency practitioners (IPs) in Ireland; the paper identifies three different narrative positions – “clinical market operators”, “blame the entrepreneurs” and “professional detachment/disidentification” – that these specialists employed to story their working experiences. Findings – The paper suggests that IPs do not have a fixed narrative schema to narrate their professional identities, as they struggle to reconcile their professional acts with their personal ambitions. These findings point to a disconnection between the political rhetoric on risk taking and the acts perpetrated on entrepreneurs who fail, a central tension in the discourse on entrepreneurship policy. Research limitations/implications – The paper adds to the current debate on business failure, an area that is typically under-researched and under-theorised in entrepreneurship studies. By offering a response to calls for more multi-perspective research, this paper makes a significant contribution to extant interpretive literature on business failure. While the method of analysing stories is widely accepted in social science research, researchers seeking to replicate this study may produce different results; this is a taken for granted outcome of the method. Practical implications – The analysis suggests that the current legislative impetus to ameliorate the implications of insolvency, driven by an aspiration to encourage second-chance entrepreneurship, faces resistance from IPs as they attempt to fulfil their professional obligations. In the absence of legislative reform, the impulse, perhaps even process necessity, of IPs to dialogically position themselves against failed entrepreneurs is likely to continue. Originality/value – The paper's originality and value arise from its unique consideration of other end of entrepreneurship; offering novel insights into the difficulties IPs have in narrating their working lives.

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