Identity Constructions of Healthcare Middle-Managers: Exploring the Two Faces of Janus

Abstract

Based on an interpretive research design, this study responds to the need to understand the complexity of middle-managers organizational life in public healthcare. Middle managers are crucial to supporting the effective and efficient delivery of healthcare services. However, we know little about how they experience and respond to their managerial function, operating at the junction of top-down and bottom-up predicaments and the double professional and managerial role. Based upon interviews with heads of medical units, nurses and administrative staff in public healthcare hospitals, and the observation of managerial actions and interactions, we explored how heads of medical units define their work identities. Four middle manager configurations were found: puppet, foreman, integrator and process promoter. The influence of each configuration on interpersonal relationships and decision making is examined. The research results invite the reader to take a closer look at the two faces of middle managers in healthcare organizations, and how they identify their role and deal with organizational complexity.