Department of Health Care Administration, California State University, Long Beach, 51250 Bellflower Boulevard, Long Beach, CA, 90840-4903, USA.
Health Care Anal. 2019 Dec;27(4):269-288. doi: 10.1007/s10728-019-00368-8.
This paper critically examines efforts to "professionalize" the field of healthcare management and its corresponding costs. Drawing upon the scholarly critiques of professionalization in medicine and the broader field of management, this paper seeks to explore the symbolic role professionalization might play in the psyche of its constituents, and specifically its function as a defense against uncertainty and anxiety. This psychodynamic heuristic is then deployed to put forth the hypothesis that an ongoing crisis of professional identity continues to both propel and impede professionalization efforts in healthcare management, giving rise to a litany of standardization pressures that ultimately limit the field's potential. To mitigate these pressures, the call is made for rekindling healthcare management's moral, political, and existential aspects. Specifically, this entails engaging with the deeper themes that flow through the field: the experience of illness and what it means to suffer, the experience of life and what it means to have hope, and the experience of death and dying. It also entails squarely confronting questions of power, poverty and disease, and the pursuit of justice.
本文批判性地考察了“专业化”医疗保健管理领域及其相应成本的努力。本文借鉴了医学和更广泛的管理领域中对专业化的学术批判,旨在探讨专业化在其组成人员的心理中可能扮演的象征性角色,特别是其作为应对不确定性和焦虑的防御机制的功能。然后,利用这种心理动力启发式方法提出假设,即专业身份的持续危机继续推动和阻碍医疗保健管理中的专业化努力,从而产生一系列标准化压力,最终限制了该领域的潜力。为了减轻这些压力,呼吁重新点燃医疗保健管理的道德、政治和存在方面。具体来说,这需要涉及贯穿该领域的更深层次主题:疾病的体验及其意味着什么,生命的体验及其意味着什么,以及死亡和临终的体验。这还需要直面权力、贫困和疾病问题,以及对正义的追求。