Sensemaking and medical professional identity within the context of strategic change

Abstract

Objective of the study: To identify how the physicians of a major Brazilian hospital perceive the proposed change in payment models for services provided and whether the proposed change affects elements of the professional identity of the physicians interviewed. Methodology / approach: This study draws on the sensemaking theory, medical professional identity and implementation of strategies in complex organizations. It was carried out a qualitative research through semi-structured interviews with a group of physicians who works in a large Brazilian hospital that was facing changes in the reimbursement model. Originality / Relevance: Research addressing the reasons why physicians tend to resist is important to help strategists to design an approach to obtain professional adherence. Main results: The research participants perceive threats to their autonomy in two attributes, Clinical Autonomy and Financial Autonomy. Regarding the change in the payment model for services rendered, some interviewees perceive their need, but demonstrate a desire for more active participation in the discussion and elaboration of new models, thus configuring the need to maintain their Political Autonomy. Theoretical / methodological contributions: This work contributes to the literature by advancing the process of understanding sensemaking triggers and demonstrating how and why threats to professional identity can hamper the process of implementing strategies in complex organizations. Social / management contributions: The implementation of strategies in hospital organizations is a topic of great relevance for the managers of the healthcare industry, due to its multiplicity of actors and interests, in addition to exponential technological evolution.