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Article
Publication date: 9 August 2011

Elsmari Bergin and Carl Savage

Professionals in academic health centers (AMCs) face multiple obligations, such as those from research, teaching and clinical care. The purpose of this study is to explore and…

526

Abstract

Purpose

Professionals in academic health centers (AMCs) face multiple obligations, such as those from research, teaching and clinical care. The purpose of this study is to explore and develop an understanding about how well findings generated from two previous studies about the influence of multiple obligations on health care personnel fit those within health care associated with academic institutions.

Design/methodology/approach

A total of 11 professionals engaged in teaching, research, and clinical work were interviewed. Data from the open‐ended interactive interviews were transcribed and compared with findings from the two previous studies, using modified analytic induction.

Findings

Work at an AMC can entail balancing three tasks: research, education, and clinical care. These tasks as well as the different employers associated with them can be a source of conflict. For a group of committed professionals, these conflicts were accepted and balanced as long as they experienced stimulus, autonomy, and variation.

Research limitations/implications

Modified analytic induction, an uncommon analysis method, is useful for comparing findings from previous studies in another context and with different subjects.

Practical implications

Stimulation, autonomy, and variation could play a vital role as driving factors in coping and dealing with the unavoidable presence of multiple obligations in today's health care systems.

Originality/value

Although AMCs combine clinical care, research, and teaching, the intersection of all three has in contrast not been investigated so thoroughly at the individual level.

Details

Journal of Health Organization and Management, vol. 25 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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Article
Publication date: 6 February 2009

Elsmari Bergin

The call for cuts and streamlining in health organizations has resulted in middle managers having more responsibilities. The main aim of this study is to explore and understand…

2815

Abstract

Purpose

The call for cuts and streamlining in health organizations has resulted in middle managers having more responsibilities. The main aim of this study is to explore and understand the way middle managers in Swedish health care organizations handle multiple obligations and continuous challenges.

Design/methodology/approach

Middle managers in health organizations were interviewed in an open‐ended, interactive mode. The transcribed interviews were analysed using grounded theory as the method of study.

Findings

The participating managers started their careers as nurses or physiotherapists and they describe their experiences of transition in role taking and transformation of earlier approaches to work assignments. An understanding of a process of managerial development is identified. During this process, the subjects are going from “being prepared” to “defining limits”, from “action” to “wait‐and‐see”, gradually regaining self‐respect and establishing authority, all to attain a non‐negotiable managerial integrity.

Practical implications

The findings can be used to support first line managers in health care, who often leave their positions in the early stages of their managerial career, as well as middle managers in their managerial development.

Originality/value

The development of managerial integrity, with support from findings in in‐depth interviews, has not been described until now.

Details

Leadership in Health Services, vol. 22 no. 1
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 1 August 2005

Elsmari Bergin and Michael Helge Rønnestad

It is well‐known that a decrease in economic resources in health care results in increased workload, stress and pressure on personnel. The main aim of this study was to explore…

989

Abstract

Purpose

It is well‐known that a decrease in economic resources in health care results in increased workload, stress and pressure on personnel. The main aim of this study was to explore and understand how personnel in health care were influenced by multiple obligations in the context of a changing surrounding.

Design/methodology/approach

Personnel within psychiatry were interviewed in an open‐ended, interactive mode. The transcribed interviews were analysed using grounded theory as the method of study.

Findings

These professionals working within a turbulent work situation experienced a struggle between external demands and internal obligations of an ethical or ideological character. For many of them earlier psychological contracts were broken, earlier organizational culture was overthrown and their professional authority was threatened. They were required to change or abandon well‐established professional identities. Fundamental changes such as the transition of theoretical framework or revision of internal obligations have quite a different timetable from a technical change of method or organizational structure.

Practical implications

The findings of two timetables for change should be addressed when considering reorganizations. If these findings are applied to personnel in health care, seeing them also as patients in the system may be avoided.

Originality/value

The different timetables for external change and internal reorganization, with support from findings in in‐depth interviews, have not been described until now.

Details

Journal of Health Organization and Management, vol. 19 no. 4/5
Type: Research Article
ISSN: 1477-7266

Keywords

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