The identity work of medical directors as collateral construction

Abstract

We examine identity work performed by autonomous professionals who undertook management roles and over time experienced shifting pressures from different sources. Over a period of 21 months, we interviewed and observed 20 physicians in four different health care organizations, as they assumed their management role as medical directors of their institutions. We identified three distinct trajectories in their identity work. In particular, individuals who were successful in the role self-defined by including indirect positive definitions of others were also found to integrate positive constructions of self in their new role and to perform it according to expectations. We refer to this interactional accomplishment as “collateral identity work” that sustains the self-narrative by including the definition of others.