Government reform of the NHS in the UK has sought to increase the involvement of doctors (clinicians) in hospital management. Using frameworks from the psychological contract and organisational misbehaviour literatures, this paper examines the processes involved when clinicians assume management roles. This literature seeks to explain breaches to expectations regarding prior agreements with management and subsequent actions of 'getting even' as a result of breaches to the employment relationship. A qualitative methodology using interviews was undertaken, which identified two distinct groups of clinician-manager. Investors actively pursued a management opportunity as an alternative to clinical medicine, whilst reluctants tended to assume a management role to protect particular specialities from outside influence or from those they thought would be inappropriate clinician-managers. Investors and reluctants often had very little prior experience of management and managers and had problems reconciling their dual clinician-management role. Poor relationships with hospital managers who often had no understanding of their dual responsibilities led to tensions and conflict, which questions continued developments in this important area of UK health policy. Suggestions for improving this process are outlined.

Although identity research in organizations has increased in recent years, none of the current perspectives has examined the role of emotion for understanding how individuals construct and enact professional identity. In this paper we examine how emotions affect the development, conduct and meanings of professional identity among a sample of 20 doctor managers from two Spanish hospitals. While not excluding other approaches, we found that a social identity approach was especially useful. The contribution of this paper is threefold. First, our results provide new insights about how, in a work setting, emotions prioritize awareness of identity issues that need attention. Second, we discuss the role of emotions for understanding complex role identities by reference to the enactment of different sides of doctor managers' identities. Third, we show how our analysis of the findings may be used to embellish the social identity approach.

Following the diffusion of HRM as the dominant legitimating managerial ideology

This article draws on a study of doctors' experiences of clinical managing to highlight research conventions that limit the development and use of middle range theories in grounded studies. Using sensemaking and the psychological contract as example frameworks, we illustrate how customary deductive evaluations of middle range theories turn grounded researchers away from theory building. As a correction to these conventions, we offer an inductive approach to building existing theory in grounded investigations that does not depend solely on working with frameworks under different empirical conditions. We suggest that forward theorizing is most likely to progress from a synthesis of fitted explanation and prospective thinking that presses at the limits of the data's usefulness. To illustrate this approach, trialled thinking about novel theoretical juxtapositions and alternative sources was used in conjunction with our clinical director data. The value of this approach was supported in two ways. First, a number of fitted and prospective conjectures are offered about how social identity articulates with psychological contracts and sensemaking in role change situations. Second, new light is shed on the process by which particular social conditions differentially modify employees' social categorizations, and how these inform employee responses to the evolving experience of role change. The article concludes with some tentative proposals for promoting more discussion of theory building in grounded investigations. Copyright Blackwell Publishing Ltd 2004.

Increases in managerial redundancies have followed in the wake of recession and fiercer competition. Although popular accounts have warned of a growing disaffection among managers, few studies have examined the effects of abandoning their traditional job security. This article examines changes in the work attachments of long-service managers under the threat of redundancy. Over a 12-month period, interviews were conducted with 42 middle managers who, at the beginning of the research, had been warned of possible redundancy. Initially, most of the managers experienced significant threats to their established views about themselves and their employers. The development of these early perceptions into altered work attachments depended largely on outcomes of the redundancy process. For reprieved managers organizational commitment was quickly re-established. In contrast, those demoted to engineering roles or reemployed by other companies became less trusting and developed new explanations of their past employment experiences. These findings illustrate the tension between the need of managers to be assured of their place within the organizational structure and recent threats to their traditional careers and employment security. Also we may expect difficulties in the development of organizational commitment to emerge as the personal risks to managers increase.