Medical management: hostage to its own history? The case of Italian clinical directors. Issue 5 (7th July 2014)

• Record Type: Journal Article
• Authors: Ingo Bode and Professor Mike Dent, Dr; Sartirana, Marco; Prenestini, Anna; Lega, Federico
• Is Part Of: International journal of public sector management. Volume 27:Issue 5(2014)
• Page Start: 417
• Page End: 429
• Publication Date: 2014-07-07
• Subjects: Government business enterprises -- Management -- Periodicals; 351
• DOI: 10.1108/IJPSM-06-2012-0070
• Languages: English
• ISSNs: 0951-3558

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title content-type="abstract-heading">Purpose</title> <p> – As a consequence of new public management reforms, leading professionals in public service organizations have increasingly been involved in management roles. The phenomenon of clinical directors in the healthcare sector is particularly representative of this, as this medical manager role has been adopted in many countries around the world. However, professionals' managerial role taking still falls quite short of expectations. While most research has searched for the causes of this gap at the individual level by exploring the clash between management and professionalism, the purpose of the paper is to argue that a contextualized understanding of the antecedents at the organizational level, and particularly the existing medical management roles, provides a more thorough picture of the reality. </p> </sec> <sec> <title content-type="abstract-heading">Design/methodology/approach</title> <p> – The paper adopts an institutional perspective to study the development of existing medical management roles and the rise of new ones (clinical directors). The analysis focuses on the case of Italy, a country with a tradition in medical management where, following the example of other countries, clinical director roles were introduced by law; yet they were not incisive. The paper is based on a review of the existing literature and extensive field research on Italian clinical directorates. </p> </sec> <sec> <title content-type="abstract-heading">Findings</title> <p> – The paper shows how in contexts in which doctors in management roles exist and are provided with legitimacy deriving from legal norms, historical settlements between professions and taken for granted arrangements, medical management becomes institutionalized, stability prevails and change towards new doctor-in-management roles is seriously hampered. </p> </sec> <sec> <title content-type="abstract-heading">Originality/value</title> <p> – The paper contributes to existing knowledge on professionals' managerial role taking, underlining the relevance of contextual and nation-specific factors on this process. It provides implications for research and for policy making in healthcare and other professional public services.</p> </sec> </abstract>