Abstract

Objective: Delivery of health care service (HCSs) is a public issue in Sweden. Managers’ decisions and strategies are expected to be open to debate, investigation and scrutiny by the media. There is, however, little knowledge about how managers at local level communicate with the media. The aim of this study is to present an empirically grounded conceptual model of how operative health care managers perceive and handle media communication in open, transparent management of public HCSs.Methods: A grounded theory approach was adopted including in-depth and follow-up interviews with 45 managers, and complemented with open-ended questions that were answered by the majority of municipal top managers of public HCSs in Sweden (n = 161).Results: Communicating with the media were interacting in spite of unequal logics and conditions regarding openness in communicating. In managers response to media misrepresentation (inaccurate, narrow and skewed reporting) of the often complex and value-laden issues of HCSs they put highlighted dignity, correctness regarding facts, and protection of integrity. Managers’ approaches were to mobilize individual and organizational resources in order to support openness and reduce uncertainties, through crafting managerial hardiness and organizational robustness, and over the longer term, by building authentic openness through awareness, control and acceptance of the conditions.Conclusions: In conclusion, handling the media can be challenging owing to different logics for reporting, but the media plays a vitally important role in the transparency of the management. Dealing with the pressure of media attention can either have negative consequences or contribute to more open and authentic internal and external communication.

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