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…
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
Keywords
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…
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
Keywords
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…
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.