Hybrid actors and role tensions: How do professional-managers negotiate an identity-based compromise?

Today French public management is exposed to numerous changes, changes which are taking the shape of performance management devolution efforts within public organizations. These evolutions aim at conferring more autonomy to actors who are closer to the field, by assigning more responsibilities to them: definition of objectives, measurement of results, resource allocation... This phenomenon is currently manifesting itself inside public hospital organizations, in the same vein that Anglo-Saxon traditions are being influenced by the "New Public Management" movement. In 2003, the French government launched the "Hospital 2007" plan, a reform aiming, among other things, at internally "remodeling" public hospitals, by making them change from traditional department based organizations to "pole of activity" based organizations. This new hospital organization gave rise to the need to create new "links" in the system. New roles consequently emerged in the organization, roles that we qualify as "hybrids" because they associate both professional activities – the practice of medicine, care... – and management activities – human resource management, team organization, financial management... Therefore, these "professional-managers" play a cross-disciplinary role in the organization, a role which, however, seems difficult to assume. First, the combination of professional and managerial functions seems problematic because of the divergent interests actors attribute to them – quality of care for the health care professional, cost of care for the manager. Besides, the "mixed" hierarchical position proves to be constraining for actors, who become "stuck" between the administrative imperatives and pole staff expectations. Our research aims at shedding light on the issue of "professional-manager" role conflicts, through an identity-based approach and through the study of identity-role interactions. Pursuing this logic, we mobilize a theoretical framework focused on both role conflict literature and identity work theory. We then compare and contrast these theoretical approaches to practical elements using document analysis and interviews which we collected from a rich case study based in a large French hospital. Next, we highlight two main results. First, we argue that hybrid actors reach compromises between their personal identity and their social identity in order to limit divergent behaviors in their daily work. We also suggest that this compromise allows actors to explore new potential roles and to favor those which appear to be the most congruent with their identities. Finally, we discuss these results in our last section, by placing them in the more global context of identity and role.