Understanding medical professionalism in the managerial era: findings from a micro-level analysis

Abstract

Within the dominant rationalistic-bureaucratic context, health organizations are expected to follow more predictable and controllable management practice. Answering the call of recent debates, this in-depth qualitative research goes deeper into the professional relations between medicine and management and explains why, despite the strengthening of managerial supervision, not all administrative measures are implemented uniformly by doctors and why the same measures do not always produce the same results. At stake are much more complex social interactions that are kept out of sight by institutional-oriented approaches to professional relations. This is a sociological perspective supported by structural, contextual and individual dimensions and goes back to classical typologies in the sociology of health to understand how a conventional and a cutting-edge medical department respond to such growing managerial pressure. The argument is that knowledge focused on ‘individual action in context’ makes it possible to understand the effects of organizational measures and explain the diversity of managerial results.