Abstract
This study explores how formal leaders at various levels experience and respond to exercising their own autonomy in relationships with superiors and staff in a knowledge-dominated healthcare organization. Proposing the notion of constrained autonomy, the study suggests a way of understanding how formal leaders in mid-level positions work within autonomy–authority tensions. Based on interviews with formal leaders, I argue that formal leaders are highly aware of and deal with the autonomy tensions that occur in contradictions between structural requirements, ability to lead, and decision-making power in such complex ways that tensions are upheld and left more ambiguous than they first appeared. Thereby, the study develops literature on autonomy tensions and leadership. It also contrasts research suggesting that formal leaders sometimes deny tensions, are unaware of them, or seek to control or eliminate them and questions the sharp division between autonomy and authority often found in literature. The notion of constrained autonomy may also assist formal leaders navigate daily workplace tensions in knowledge-dominated healthcare contexts.
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