Att leda läkare utan att själv vara läkare : En studie om villkorad chefslegitimitet och professionella gränser i specialiserad vård

Sammanfattning

This study examines what makes physicians in specialised healthcare ascribelegitimacy to non-physician managers. It takes its point of departure in thetension between the manager’s formal right to lead and the medicalprofession’s strong knowledge base, autonomy and jurisdiction. The empiricalmaterial consists of six semi-structured interviews with physicians who haveexperience of having a direct manager who is not a physician. The materialwas analysed using thematic analysis, drawing on symbolic interactionism,Suchman’s typology of legitimacy and sociology of professions perspectiveson knowledge and jurisdiction. The results show that the legitimacy of the non-physician manager is shapedthrough physicians’ interpretations of managerial actions. Legitimacy isstrengthened when the manager is perceived as understanding physicians’working conditions, listening to their medical assessments, respectingprofessional boundaries and taking responsibility for matters within themanagerial mandate. Being a physician may provide a stronger initial positionin the legitimacy assessment, but it does not appear to be an absoluterequirement for leading physicians. Legitimacy assessments are shaped byphysicians’ previous individual experiences and by collective interpretationsformed within the physician group as a professional community. The studyconcludes that it is possible to lead physicians without being a physicianoneself, but that legitimacy is conditional on whether the manager’s actionsare interpreted as expressing understanding, respect and responsibility inrelation to the professional order surrounding physicians’ work.