BackgroundThe New Public Management movement strove for transparency so that policy makers and citizens could gain insight into the work and performance of health care. As the use of the electronic health record (EHR) started to diffuse, a foundation was laid for enhanced transparency within and between health care organizations. Now we appear to be experiencing a new kind of transparency in the health care sector. Many health care providers offer their patients online access to their EHRs (here referred to as Open Notes). The Open Notes system enables and strives for transparency between the health care organization and the patient. Hence, this study investigates health care professional (HCP) perceptions of Open Notes and deepens the understanding of the transparency that Open Notes implies.ObjectiveBased on two survey studies of HCP perceptions of Open Notes, this paper aims to deepen the academic writing on the type of transparency that is connected to Open Notes.MethodsHCPs in adult psychiatry in Region Skåne, Sweden, were surveyed before and after implementation of Open Notes. The empirical material presented consists of 1554 free-text answers from two Web surveys. A qualitative content analysis was performed.ResultsThe theoretically informed analysis pivots around the following factors connected to transparency: effectiveness; trust; accountability; autonomy and control; confidentiality, privacy, and anonymity; fairness; and legitimacy. The results show that free-text answers can be sorted under these factors as trade-offs with transparency. According to HCPs, trade-offs affect their work, their relationship with patients, and not least, their work tool, the EHR. However, since many HCPs also state that they have not met many patients, and in some cases none, who have read their EHRs, these effects seem to be more connected to the possibility (or threat) of transparency than to the actual effectuated transparency.ConclusionsThe implementation (or reform) of Open Notes is policy driven while demanding real-time transparency on behalf of citizens/patients and not the authorities, which makes this particular form of transparency quite unique and interesting. We have chosen to call it governed individual real-time transparency. The effects of Open Notes may vary between different medical specialties relative to their sensitivity to both total and real-time transparency. When HCPs react by changing their ways of writing notes, Open Notes can affect the efficiency of the work of HCPs and the service itself in a negative manner. HCP reactions are aimed primarily at protecting patients and their relatives as well as their own relationship with the patients and secondly at protecting themselves. Thus, governed individual real-time transparency that provides full transparency of an actual practice in health care may have the intended positive effects but can also result in negative trade-offs between transparency and efficiency of the actual practice. This may imply that full transparency is not always most desirable...

Gendering processes often take the form of organizational subtexts, that is, seemingly gender-neutral practices that have gender implications. The purpose of this article is to study performance evaluations, which, based on management by objectives systems, may appear neutral, but tend to be based on male norms of what is regarded as good performance. We analysed the careers and performance evaluations of 391 newly licenced Swedish auditors, using an open-ended question survey. In this industry 50 per cent of new employees and 92 per cent of partners are men. Even in the early stages of their careers, there are notable differences between women and men. The women achieved less and show lower career ambitions and expectations as well as greater intentions to leave the auditing industry. Performance evaluations are also perceived differently, men focusing on what is evaluated (reflecting the perceptions of those at higher hierarchical levels) and women focusing on who does the evaluating and how.

The article introduces a framework for understanding women's entry into the academic world and how it interacts with internal departmental structures and practices. It presents three specific strategies applied by a group of women to gain a doctorate and acceptance in their department. Few previous studies have stressed women's strategies to cope with the organizational setting in academia. The article draws on previous research on women in academia and how organizational characteristics influence women's careers. It is based on a case study of a Swedish university department. Sweden is often recognized for creating favourable working conditions for women. Yet the Swedish academic world is very maledominated at the top and even the medium level. It is also more common than in many other Western countries that academics stay on at the department where they graduated. Therefore, a PhD is often a first step in a career within that department.

The introduction of a new corporate governance code in Sweden, modeled after prevailing Anglo‐Saxon norms of corporate governance, offers the opportunity to investigate global regulatory convergence. Using the metaphor of regulatory space, this article analyzes the positions of the parties who submitted formal responses to the introduction of “The Swedish Code of Corporate Governance—A Proposal from the Code Group.” While the globalization of financial markets might forecast unconditional acceptance of the proposed code by business and financial interests, the analysis of who made comments, and what was said, reveals three categorically distinct groups: Swedish business “insiders” connected to the existing institutional framework who opposed changes that would erode traditional division of functions, including collective responsibility for the actions of company boards; “outsiders” (i.e., foreign investors and more marginal Swedish investors) aligned with Anglo‐Saxon internationalization of the markets who would change the system of corporate accountability; and the professions (i.e., auditors), who advocated for their professional interests. Of the three groups, Swedish business insiders were most successful in gaining support for their positions. Although international financial and political interests were key to the introduction of the Code in the first place, the article demonstrates how the dynamics of national (local) culture and power structures influence the transfer of regulatory law across jurisdictions.

PurposeThis study aims to examine the association between auditor and chief financial officer (CFO) gender and earnings quality, utilising data from Sweden. This study also aims to examine whether interactions between auditor and CFO, which may affect a firm’s earnings quality, are associated with their gender. These aims are inspired by the notion that gender differences will be overruled by the rewards and socialisation into the occupational roles as suggested by the structural approach to gender. Design/methodology/approachThis study uses a multivariate regression model to test its hypotheses. The sample consists of 976 firm-year observations covering the period 2008 to 2013. FindingsThe results show that gender of the auditor and CFO is not associated with earnings quality, and the interactions between auditors and CFOs, which may affect earnings quality, are not associated with their gender. Consequently, the results give tentative support for the structural approach in gender studies in the accounting and auditing field. Research limitations/implicationsThis study indicates that future research in gender studies should consider the structural approach based on the argument of gender similarities. This approach contends that work-related behaviour of women will more resemble men, and this is caused by the socialisation process into the occupational role and the structure where they work (e.g. organisational and professional culture, work conditions, a compensation scheme, national culture, etc.) instead of gender. Originality/valueThis study contributes to the understanding whether gender – auditor and CFO gender – is associated with firms’ earnings quality and standing whether the interactions between auditor and CFO are associated with their gender, something that, to the best of the authors’ knowledge, has not been tested previously. It also re-introduces the structural approach within the gender research in the accounting and auditing field.