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DOCTORS AS MANAGERS - New Public Management in a New Zealand hospital

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  • Bill Doolin

Abstract

In a corporatized New Zealand public hospital, senior management introduced a strategy of ‘clinical leadership’ intended to incorporate clinicians more fully within some system of organizational control, and to make them accountable for the resources consumed as a consequence of their treatment decisions. An organizational restructuring created semiautonomous business units based around clinical specialities and headed by clinician managers. Clinician managers played a boundary role between their professional colleagues and management. In the short term, a number of senior clinicians adapted to this role and there was some evidence for their acculturation into managerial identifications. However, the majority of clinician managers acted to absorb change rather than actively champion change. For many clinical units, clinical practice continued more or less unchanged. The concept of loosely coupled systems is used to explain this separation of internal operations from organizational form.

Suggested Citation

  • Bill Doolin, 2001. "DOCTORS AS MANAGERS - New Public Management in a New Zealand hospital," Public Management Review, Taylor & Francis Journals, vol. 3(2), pages 231-254, June.
    • Handle: RePEc:taf:pubmgr:v:3:y:2001:i:2:p:231-254
    DOI: 10.1080/14616670010029601
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    Cited by:

    1. Les Worrall & Kim Mather & Roger Seifert, 2010. "Solving the Labour Problem Among Professional Workers in the UK Public Sector: Organisation Change and Performance Management," Public Organization Review, Springer, vol. 10(2), pages 117-137, June.
    2. Ancarani, Alessandro & Di Mauro, Carmela & Gitto, Simone & Mancuso, Paolo & Ayach, Ali, 2016. "Technology acquisition and efficiency in Dubai hospitals," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 475-485.
    3. Macinati, Manuela S. & Rizzo, Marco G., 2014. "Budget goal commitment, clinical managers’ use of budget information and performance," Health Policy, Elsevier, vol. 117(2), pages 228-238.
    4. Jimmy Vallejo & Nathalie Sampieri-Teissier & Christophe Baret, 2015. "Comprendre les difficultés de la mise en œuvre de la délégation de gestion à l’hôpital. Une lecture par le concept d’anarchie organisée," Post-Print hal-01404762, HAL.
    5. Geoffrey Leuridan & Benoît Demil, 2022. "Exploring the dynamics of slack in extreme contexts," Post-Print hal-03931024, HAL.
    6. Margaret Brunton, 2017. "Risking the Sustainability of the Public Health System: Ethical Conundrums and Ideologically Embedded Reform," Journal of Business Ethics, Springer, vol. 142(4), pages 719-734, June.
    7. Jimmy Vallejo & Nathalie Sampieri-Teissier & Christophe Baret, 2015. "Comprendre les difficultés de la mise en oeuvre de la délégation de gestion à l'hôpital. Une lecture par le concept d'anarchie organisée," Post-Print halshs-01416926, HAL.
    8. Macinati, Manuela S. & Bozzi, Stefano & Rizzo, Marco Giovanni, 2016. "Budgetary participation and performance: The mediating effects of medical managers’ job engagement and self-efficacy," Health Policy, Elsevier, vol. 120(9), pages 1017-1028.
    9. Julia Segar & Kath Checkland & Anna Coleman & Imelda McDermott & Stephen Harrison & Stephen Peckham, 2014. "Changing the Ties That Bind? The Emerging Roles and Identities of General Practitioners and Managers in the New Clinical Commissioning Groups in the English NHS," SAGE Open, , vol. 4(4), pages 21582440145, October.
    10. Jimmy Vallejo, 2016. "Understanding the difficulties of implementing management delegation in hospitals: a reading through the concept of organised anarchy," Post-Print hal-01404682, HAL.
    11. van den Broek & Boselie & Paauwe, 2014. "Multiple Institutional Logics in Health Care: 'Productive Ward: Releasing Time to Care'," Public Management Review, Taylor & Francis Journals, vol. 16(1), pages 1-20, January.
    12. Maria Lusiani, 2013. "Formal planning and the reshaping of public sector professional work," Working Papers 33, Venice School of Management - Department of Management, Università Ca' Foscari Venezia.

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