Are new forms of professionalism emerging in medicine? The case of the implementation of NICE guidelines

Spyridonidis, Dimitrios; Calnan, Michael

doi:10.5172/hesr.2011.356

Cited by 13 publications

(27 citation statements)

References 27 publications

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“…Others may be slower to alter more traditional conceptualisations of their identity (Spyridonidis and Calnan 2011). In understanding how professionals embrace or resist new organisational hybrid roles (in our case physician-manager) most existing empirical studies lack convincing theoretical explanation.…”

Section: Professional Autonomymentioning

confidence: 96%

“…Within this new landscape physicians are often positioned as 'physician-managers'. These new hybrids are embedded in a policy regime of measurement and transparency (Power 1999;Meier and Hill 2005), the desire to pursue 'value for money' (Dent 1995;Halford and Leonard 1999;Doolin 2002) and the alignment of professional autonomy with clinical performance (Ferlie and McGivern 2013;McDonald et al 2006;Spyridonidis and Calnan 2011). As new managerial roles are introduced, physicians are now required to act or think from a managerial and medical perspective, in a new form of hybrid working.…”

Section: Medical Professional Identity and Managerial Discourse In Thmentioning

confidence: 99%

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Understanding Hybrid Roles: The Role of Identity Processes Amongst Physicians

Spyridonidis

Hendy

Barlow

2014

Public Administration

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100

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Increasing attention has been paid in both public administration and organizational theory to understanding how physicians assume a ‘hybrid’ role as they take on managerial responsibilities. Limited theoretical attention has been devoted to the processes involved in negotiating, developing, and maintaining such a role. We draw on identity theory, using a qualitative, five‐year longitudinal case study, to explore how hybrid physician–managers in the English National Health Service and the organizations they are situated in achieve this. We highlight the importance of saliency – how central an identity is to an individual's values and beliefs – in managing new identities. We found three differing responses to taking on a hybrid physician–manager role, with identity emerging as a mitigating factor for negotiating potentially conflicting roles. We discuss the implications for existing theory and practice in the management of public organizations and identify an agenda for further research.

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Section: Professional Autonomymentioning

confidence: 96%

Section: Medical Professional Identity and Managerial Discourse In Thmentioning

confidence: 99%

Understanding Hybrid Roles: The Role of Identity Processes Amongst Physicians

Spyridonidis

Hendy

Barlow

2014

Public Administration

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100

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“…The devolution of fiscal responsibility to certain professionals has continued, with both doctors and nurses assuming greater responsibility for the utilisation of NHS resources, resulting in professional restratification (Freidson 1988) and the development of 'new' professional roles for individuals such as clinical directors and nurse managers, a case of poachers turned gamekeepers (Ham 2009) or professional mediators (Spyridonidis and Calnan 2011). However, this notion of professional responsibility for resource management has continued to develop and in this article it will be argued that an ethos of a 'new professionalism' is now visible in NHS policy and reports, which is directed not just at the professional elite but at all clinicians. Consequently, this article aims to explore the emerging notion of a new professionalism, specifically via the construction of productivity in contemporary NHS policy discourse.…”

Section: Introductionmentioning

confidence: 99%

Constructing notions of healthcare productivity: the call for a new professionalism?

Moffatt

Martin

Timmons

2013

Sociology Health & Illness

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Improving performance is an imperative for most healthcare systems in industrialised countries. This article considers one such system, the UK's National Health Service (NHS). Recent NHS reforms and strategies have advocated improved healthcare productivity as a fundamental objective of policy and professional work. This article explores the construction of productivity in contemporary NHS discourse, analysing it via the Foucauldian concept of governmentality. In this manner it is possible to investigate claims that the commodification of health work constitutes a threat to autonomy, and counter that with an alternative view from a perspective of neoliberal self-governance. Contemporary policy documents pertaining to NHS productivity were analysed using discourse analysis to examine the way in which productivity was framed and how responsibility for inefficient resource use, and possible solutions, were constructed. Data reveals the notion of productivity as problematic, with professionals as key protagonists. A common narrative identifies traditional NHS command/control principles as having failed to engage professionals or having been actively obstructed by them. In contrast, new productivity narratives are framed as direct appeals to professionalism. These new narratives do not support deprofessionalisation, but rather reconstruct responsibilities, what might be called 'new professionalism', in which productivity is identified as an individualised professional duty.

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“…Furthermore, given recent efforts to reform the financing and delivery of health care, the degree to which the perceived medical autonomy by physicians is preserved can be valuable information (Spyridonidis & Calnan, 2011). Our research demonstrates the usefulness of the concepts of reciprocity and the psychological contract in understanding and improving hospital-physician relationships.…”

Section: Discussionmentioning

confidence: 87%

In the eye of the beholder: A qualitative study of mutual obligations and areas of ambiguity in the hospital–physician relationship

Trybou

Gemmel

Annemans

2014

International Journal of Healthcare Management

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Hospitals and physicians have been working together for years in providing specialized health services. However, Hospital-Physician Relationships are considered lukewarm at best.We build on psychological contract theory to develop an in-depth understanding of how physicians (N=15) and hospital executives (N=15) in Belgium experience and interpret obligations in their working relationship. Our analysis yielded a rich understanding of mutual obligations and areas of ambiguity. Two major themes emerged from the analysis. A distinction should be made between administrative obligations (adequate support and responsive decision making) and professional obligations (clinical excellence and physician autonomy). Two areas of ambiguity could be identified reflecting both dimensions. An economic trade-off exists in the day-to-day interaction and therefore views on how the way care should be organized differ. In addition, the extent to which medical decisions should take into account the corresponding impact on hospital finance varies.

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Are new forms of professionalism emerging in medicine? The case of the implementation of NICE guidelines

Cited by 13 publications

References 27 publications

Understanding Hybrid Roles: The Role of Identity Processes Amongst Physicians

Understanding Hybrid Roles: The Role of Identity Processes Amongst Physicians

Constructing notions of healthcare productivity: the call for a new professionalism?

In the eye of the beholder: A qualitative study of mutual obligations and areas of ambiguity in the hospital–physician relationship

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