Craft, Reflexivity, and the Clinical Practice of Management

Abstract

Management is a craft and reflexivity can enhance how this craft is practiced. Alas, organizations seldom provide circumstances that are conducive to reflexivity and individualize responsibility for reflexivity. This paper posits that the clinical practice of medicine provides an instructive example for how reflexivity can be organized for, i.e., formalized and routinized, in craft-based work. Clinical practice is defined by systematic analysis, on-going peer review and routinized teaching and these features of clinical practice embed reflexivity in organizational processes. We show how systematic analysis, on-going peer review and routinized teaching can be organized for with varying intensity in a management context, and how leading-edge organizations seem to have already embrace quite sophisticated versions of them (albeit in a piecemeal fashion). Some of these activities already happen unsystematically in organizations, but we make the case that practicing management according to a clinical model may benefit organizations in substantive ways. Most notably, these benefits are likely to include a reduction of unnecessary interventions, an improvement in the quality of interventions, a facilitation of organizational coordination, and a reduction in the need for managerial talent.