Department of Policy Analysis and Public Management, and CERGAS, Università Bocconi, Milan, Italy.
Sociol Health Illn. 2012 May;34(4):626-44. doi: 10.1111/j.1467-9566.2011.01393.x. Epub 2011 Sep 19.
In the last three decades, medical doctors have increasingly been exposed to management control measures. This phenomenon has been reflected in a number of studies in various disciplines, including sociology, organisation studies, management, and health service research. This article seeks to provide a comprehensive overview of the studies dealing with the impact of management on professional control. In particular, it seeks to bridge the diversity of assumptions, theoretical perspectives and conceptual underpinnings at play, by exploring synergies between them and opening up new horizons for research. The review shows how the relationship between clinicians and management has been analysed at an organisational level using two interconnected analytical frameworks focusing on the sociocultural and task-related dimensions of professionalism. In the final discussion, we argue that comparative, longitudinal and cross-sectional research is necessary, and there is a need to overcome the hegemony/resistance framework in current analyses of the impact of management on professionalism. Such an approach would contribute to the revision of macro theories of professionalism and stimulate emerging research by examining different perspectives towards management in medical specialisations. This approach might also stimulate a discussion of medical professionals' relationships with members of other professional groups, including nurses and healthcare managers.
在过去的三十年中，越来越多的医生接触到了管理控制措施。这种现象在社会学、组织研究、管理和卫生服务研究等多个学科的研究中都有所反映。本文旨在全面概述有关管理对专业控制影响的研究。特别是，它试图通过探索它们之间的协同作用并为研究开辟新的视野，弥合各种假设、理论视角和概念基础之间的多样性。综述表明，临床医生与管理之间的关系是如何在组织层面上通过两个相互关联的分析框架进行分析的，这两个分析框架侧重于专业性的社会文化和任务相关维度。在最后的讨论中，我们认为有必要进行比较、纵向和横断面研究，需要克服当前管理对专业性影响分析中的霸权/抵制框架。这种方法将有助于修订专业性的宏观理论，并通过研究医学专业中对管理的不同看法，激发新兴研究。这种方法还可能引发对医疗专业人员与其他专业群体（包括护士和医疗保健管理人员）成员关系的讨论。
