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The role of professional elites in healthcare governance: Exploring the work of the medical director

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  • Jones, Lorelei
  • Fulop, Naomi

Abstract

Medical leaders occupy a prominent position in healthcare policy in many countries, both in terms of the governance of quality and safety within healthcare organisations, and in broader system-wide governance. There is evidence that having doctors on hospital boards is associated with higher quality services. What is not known is how they have this effect. Analysing data collected from observations, interviews and documents from 15 healthcare providers in England (2014–2019), we elaborate the role of medical directors in healthcare governance as ‘translation work’, ‘diplomatic work’, and ‘repair work’. Our study highlights the often enduring emotional effects of repeated structural changes to clinical services. It also contributes to theories of professional restratification, showing the work of medical directors as regional ‘political elites’, and as ‘corporate elites’ in publicly-funded healthcare systems.

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  • Jones, Lorelei & Fulop, Naomi, 2021. "The role of professional elites in healthcare governance: Exploring the work of the medical director," Social Science & Medicine, Elsevier, vol. 277(C).
    • Handle: RePEc:eee:socmed:v:277:y:2021:i:c:s0277953621002148
    DOI: 10.1016/j.socscimed.2021.113882
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    References listed on IDEAS

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    1. Bryce, Marie & Luscombe, Kayleigh & Boyd, Alan & Tazzyman, Abigail & Tredinnick-Rowe, John & Walshe, Kieran & Archer, Julian, 2018. "Policing the profession? Regulatory reform, restratification and the emergence of Responsible Officers as a new locus of power in UK medicine," Social Science & Medicine, Elsevier, vol. 213(C), pages 98-105.
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    3. Veronesi, Gianluca & Kirkpatrick, Ian & Vallascas, Francesco, 2013. "Clinicians on the board: What difference does it make?," Social Science & Medicine, Elsevier, vol. 77(C), pages 147-155.
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    5. Beth A. Bechky, 2011. "Making Organizational Theory Work: Institutions, Occupations, and Negotiated Orders," Organization Science, INFORMS, vol. 22(5), pages 1157-1167, October.
    6. Fulop, Naomi & Protopsaltis, Gerasimos & King, Annette & Allen, Pauline & Hutchings, Andrew & Normand, Charles, 2005. "Changing organisations: a study of the context and processes of mergers of health care providers in England," Social Science & Medicine, Elsevier, vol. 60(1), pages 119-130, January.
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    Cited by:

    1. Waring, Justin & Bishop, Simon & Clarke, Jenelle & Roe, Bridget, 2023. "Becoming active in the micro-politics of healthcare re-organisation: The identity work and political activation of doctors, nurses and managers," Social Science & Medicine, Elsevier, vol. 333(C).
    2. Haaland, Inga & Metta, Emmy & Moen, Kåre, 2023. "The use of PrEP among men who have sex with men and transgender women as Biomedical Prevention Work: A conceptual framework," Social Science & Medicine, Elsevier, vol. 333(C).

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