IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v277y2021ics0277953621002148.html
   My bibliography  Save this article

The role of professional elites in healthcare governance: Exploring the work of the medical director

Author

Listed:
  • Jones, Lorelei
  • Fulop, Naomi

Abstract

Medical leaders occupy a prominent position in healthcare policy in many countries, both in terms of the governance of quality and safety within healthcare organisations, and in broader system-wide governance. There is evidence that having doctors on hospital boards is associated with higher quality services. What is not known is how they have this effect. Analysing data collected from observations, interviews and documents from 15 healthcare providers in England (2014–2019), we elaborate the role of medical directors in healthcare governance as ‘translation work’, ‘diplomatic work’, and ‘repair work’. Our study highlights the often enduring emotional effects of repeated structural changes to clinical services. It also contributes to theories of professional restratification, showing the work of medical directors as regional ‘political elites’, and as ‘corporate elites’ in publicly-funded healthcare systems.

Suggested Citation

  • Jones, Lorelei & Fulop, Naomi, 2021. "The role of professional elites in healthcare governance: Exploring the work of the medical director," Social Science & Medicine, Elsevier, vol. 277(C).
    • Handle: RePEc:eee:socmed:v:277:y:2021:i:c:s0277953621002148
    DOI: 10.1016/j.socscimed.2021.113882
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953621002148
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2021.113882?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Fulop, Naomi & Protopsaltis, Gerasimos & King, Annette & Allen, Pauline & Hutchings, Andrew & Normand, Charles, 2005. "Changing organisations: a study of the context and processes of mergers of health care providers in England," Social Science & Medicine, Elsevier, vol. 60(1), pages 119-130, January.
    2. Veronesi, Gianluca & Kirkpatrick, Ian & Vallascas, Francesco, 2013. "Clinicians on the board: What difference does it make?," Social Science & Medicine, Elsevier, vol. 77(C), pages 147-155.
    3. Goodall, Amanda H., 2011. "Physician-leaders and hospital performance: Is there an association?," Social Science & Medicine, Elsevier, vol. 73(4), pages 535-539, August.
    4. Griffiths, Lesley & Hughes, David, 2000. "Talking contracts and taking care: managers and professionals in the British National Health Service internal market," Social Science & Medicine, Elsevier, vol. 51(2), pages 209-222, July.
    5. Bryce, Marie & Luscombe, Kayleigh & Boyd, Alan & Tazzyman, Abigail & Tredinnick-Rowe, John & Walshe, Kieran & Archer, Julian, 2018. "Policing the profession? Regulatory reform, restratification and the emergence of Responsible Officers as a new locus of power in UK medicine," Social Science & Medicine, Elsevier, vol. 213(C), pages 98-105.
    6. Beth A. Bechky, 2011. "Making Organizational Theory Work: Institutions, Occupations, and Negotiated Orders," Organization Science, INFORMS, vol. 22(5), pages 1157-1167, October.
    7. Jones, Lorelei & Exworthy, Mark, 2015. "Framing in policy processes: A case study from hospital planning in the National Health Service in England," Social Science & Medicine, Elsevier, vol. 124(C), pages 196-204.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Haaland, Inga & Metta, Emmy & Moen, Kåre, 2023. "The use of PrEP among men who have sex with men and transgender women as Biomedical Prevention Work: A conceptual framework," Social Science & Medicine, Elsevier, vol. 333(C).
    2. Waring, Justin & Bishop, Simon & Clarke, Jenelle & Roe, Bridget, 2023. "Becoming active in the micro-politics of healthcare re-organisation: The identity work and political activation of doctors, nurses and managers," Social Science & Medicine, Elsevier, vol. 333(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fraser, Alec & Baeza, Juan & Boaz, Annette & Ferlie, Ewan, 2019. "Biopolitics, space and hospital reconfiguration," Social Science & Medicine, Elsevier, vol. 230(C), pages 111-121.
    2. Shimaa Elkomy & Zahra Murad & Veronica Veleanu, 2018. "Does Leadership Matter for Healthcare Service Quality? Evidence from NHS England," Working Papers in Economics & Finance 2018-08, University of Portsmouth, Portsmouth Business School, Economics and Finance Subject Group.
    3. De Regge, Melissa & Eeckloo, Kristof, 2020. "Balancing hospital governance: A systematic review of 15 years of empirical research," Social Science & Medicine, Elsevier, vol. 262(C).
    4. Sara Korlén & Isis Amer‐Wåhlin & Peter Lindgren & Ulrica von Thiele Schwarz, 2019. "Exploring staff experience of economic efficiency requirements in health care: A mixed method study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1439-1455, October.
    5. Merlijn C P van de Riet & Mathilde A Berghout & Martina Buljac-Samardžić & Job van Exel & Carina G J M Hilders, 2019. "What makes an ideal hospital-based medical leader? Three views of healthcare professionals and managers: A case study," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    6. Kaiser, Florian & Schmid, Andreas & Schlüchtermann, Jörg, 2020. "Physician-leaders and hospital performance revisited," Social Science & Medicine, Elsevier, vol. 249(C).
    7. Nicholas Bloom & Renata Lemos & Raffaella Sadun & John Van Reenen, 2020. "Healthy Business? Managerial Education and Management in Health Care," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 506-517, July.
    8. Alla Mostepaniuk & Turgay Akalin & Mohammad Reza Parish, 2023. "Practices Pursuing the Sustainability of A Healthcare Organization: A Systematic Review," Sustainability, MDPI, vol. 15(3), pages 1-21, January.
    9. Emilio J. Castilla & Aruna Ranganathan, 2020. "The Production of Merit: How Managers Understand and Apply Merit in the Workplace," Organization Science, INFORMS, vol. 31(4), pages 909-935, July.
    10. Goodall, Amanda H. & Osterloh, Margit, 2015. "Women Have to Enter the Leadership Race to Win: Using Random Selection to Increase the Supply of Women into Senior Positions," IZA Discussion Papers 9331, Institute of Labor Economics (IZA).
    11. Avner Offer, 2012. "A Warrant for Pain: Caveat Emptor vs. the Duty of Care in American Medicine, c. 1970-2010," Oxford University Economic and Social History Series _102, Economics Group, Nuffield College, University of Oxford.
    12. Masashi Goto, 2020. "Theorization of Institutional Change in the Rise of Artificial Intelligence," Discussion Paper Series DP2020-12, Research Institute for Economics & Business Administration, Kobe University.
    13. Florence Allard-Poesi, 2015. "Dancing in the Dark: Making Sense of Managerial Roles during Strategic Conversations," Working Papers hal-01145772, HAL.
    14. Jacqueline N. Lane & Ina Ganguli & Patrick Gaule & Eva Guinan & Karim R. Lakhani, 2021. "Engineering serendipity: When does knowledge sharing lead to knowledge production?," Strategic Management Journal, Wiley Blackwell, vol. 42(6), pages 1215-1244, June.
    15. Fulop, Naomi & Walters, Rhiannon & 6, Perri & Spurgeon, Peter, 2012. "Implementing changes to hospital services: Factors influencing the process and ‘results’ of reconfiguration," Health Policy, Elsevier, vol. 104(2), pages 128-135.
    16. Manish Mohan Baral & Amitabh Verma, 2021. "Cloud Computing Adoption for Healthcare: An Empirical Study Using SEM Approach," FIIB Business Review, , vol. 10(3), pages 255-275, September.
    17. Florence Allard-Poesi, 2015. "Dancing in the dark: Making sense of managerial roles during strategic conversations," Post-Print hal-01490734, HAL.
    18. Wyffels, Eric & Beles, Monika & Baeyens, Ann & Croeckaert, Kristien & De Potter, Tom & Van Camp, Guy & Collet, Carlos & Sonck, Jeroen & Vanderheyden, Marc & Bartunek, Jozef & Barbato, Emanuele & Bermp, 2023. "Same Day Discharge Strategy by Default in a Tertiary Catheterization Laboratory in Belgium: Value Based Healthcare-Change in Practice," Health Policy, Elsevier, vol. 132(C).
    19. Kuroda, Sachiko & Yamamoto, Isamu, 2018. "Good boss, bad boss, workers’ mental health and productivity: Evidence from Japan," Japan and the World Economy, Elsevier, vol. 48(C), pages 106-118.
    20. Novak, Sonja & Djordjevic, Nebojša, 2019. "Information system for evaluation of healthcare expenditure and health monitoring," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 520(C), pages 72-80.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:277:y:2021:i:c:s0277953621002148. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.