Brown Brian, Crawford Paul
Faculty of Health and Community Studies, De Montfort University, Milton Keynes, UK.
Soc Sci Med. 2003 Jan;56(1):67-81. doi: 10.1016/s0277-9536(02)00008-4.
Health professionals have often been described as if they were in conflict with the new managerialist spirit in health care. However, because of their distributed and mobile sites of intervention, the work of community teams presents particular problems for traditional notions of management. In this UK study we identify how mental health team members are regulated by means of a subtle 'deep management'. Team members point to a lack of management direction from senior colleagues, even though some of them participate in the management process themselves. However, the lack of overt management leads them to prioritise clients and foreground professional identities in performing their duties and much additional administrative work besides. This also meant that the organisational structure-the team-was defined in subjective terms. Participants had become self-regulating 'deep managed' subjects under a largely hands-off management regime.
卫生专业人员常常被描述为似乎与医疗保健领域新的管理主义精神相冲突。然而，由于社区团队的干预地点分散且流动，其工作给传统管理观念带来了特殊问题。在这项英国研究中，我们确定了心理健康团队成员是如何通过一种微妙的“深度管理”方式受到监管的。团队成员指出，尽管他们中的一些人自己也参与管理过程，但缺乏来自上级同事的管理指导。然而，缺乏公开的管理导致他们在履行职责以及处理大量额外行政工作时，将客户置于优先地位并突出专业身份。这也意味着组织结构——团队——是以主观方式定义的。在很大程度上不干预的管理体制下，参与者已成为自我监管的“深度管理”对象。
