IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v69y2009i7p1063-1071.html
   My bibliography  Save this article

Health professionals' enactment of their accountability obligations: Doing the best they can

Author

Listed:
  • Freeman, Andrew R.
  • McWilliam, Carol L.
  • MacKinnon, Joyce R.
  • DeLuca, Sandra
  • Rappolt, Susan G.

Abstract

In the current context of health care, health professionals' accountability obligations may be more extensive than the degree of autonomy that they are permitted to exercise. To date, how professionals fulfil their obligations with regard to this potential for dissonance has not been investigated. The purpose of this Grounded Theory study was to examine how one professional group, occupational therapists, enacted their accountability obligations within their current practice context. Interviews with 21 therapists across three practice sectors in one Canadian province elicited a detailed portrait of the contextual elements within which accountability enactment took place, and a view of the dynamic interplay of these elements with the decision-making involved in fulfilling professional accountabilities. Practitioners moved back and forth between conscious juggling of accountability expectations and more automatically applying tacit practice knowledge. Beyond non-negotiable bottom line commitments to their formal ethical obligations and to retaining autonomy for their clinical recommendations, practitioners' decisions reflected the goal of doing their best. However, participants' efforts to find a balance between satisfactorily fulfilling their obligations and acknowledging the frequently unavoidable reality of contextual constraints elicited inconsistent patterns. The study findings raise concerns about ensuring quality of services and the impact on professionals. Although practitioners have an important role to play in addressing these challenges, other stakeholders, for example, the professional regulatory bodies, also must play a role in creating a coherent accountability framework. Further research is needed to obtain greater understanding of professional accountability enactment across health professions, practice sectors and health jurisdictions, and to explore managerial and professional regulatory bodies' perspectives, roles and responsibilities.

Suggested Citation

  • Freeman, Andrew R. & McWilliam, Carol L. & MacKinnon, Joyce R. & DeLuca, Sandra & Rappolt, Susan G., 2009. "Health professionals' enactment of their accountability obligations: Doing the best they can," Social Science & Medicine, Elsevier, vol. 69(7), pages 1063-1071, October.
  • Handle: RePEc:eee:socmed:v:69:y:2009:i:7:p:1063-1071
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(09)00477-8
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

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

    Citations

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


    Cited by:

    1. Petrakaki, Dimitra & Klecun, Ela & Cornford, Tony, 2016. "Changes in healthcare professional work afforded by technology: the introduction of a national electronic patient record in an English hospital," LSE Research Online Documents on Economics 59475, London School of Economics and Political Science, LSE Library.

    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:69:y:2009:i:7:p:1063-1071. 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.

    We have no bibliographic references for this item. You can help adding them by using 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.