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.

The relevance of the planning approach for innovative and for young entrepreneurial firms had been subject to debate. It has been argued that planning dampens the realisation of entrepreneurial vision. This study examines the enacted strategy approaches of entrepreneurs who had studied on a Graduate Enterprise programme that aimed to help them to start a business. The approaches they used to strategy formation were compared to the planning approach that had been emphasised to them seven to 12 years earlier. Data were gathered through non-directive interviews, and were analysed using survey and case study methods. The formation of strategy by these entrepreneurs relied more on emergent than planning approaches, but some elements of the planning approach were strongly associated with growth. Some key resources were essential for the firms and their strategy formation processes. These were key personal relationships, with whom and through whom the entrepreneurs found ways of enacting their visions ± the essence of their strategy process. Implications for curriculum and course development are given.

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