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To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2009.01157.x Byline: Ian Kirkpatrick (1), Peter Kragh Jespersen (2), Mike Dent (3), Indareth Neogy (4) Keywords: medicine; management; path dependency; re-stratification; professions Abstract: Abstract In health systems around the world the current trend has been for doctors to increase their participation in management. This has been taken to imply a common process of re-stratification with new divisions emerging between medical elites and the rank and file. However, our understanding of this change remains limited and it is open to question just how far one can generalise. In this paper we investigate this matter drawing on path dependency theory and ideas from the sociology of professions. Focusing on public management reforms in the hospital sectors of two European countries - Denmark and England - we note similarities in the timing and objectives of reforms, but also differences in the response of the medical profession. While in both countries new hybrid clinical management roles have been created, this process has advanced much further and has been more strongly supported by the medical profession in Denmark than in England. These findings suggest that processes of re-stratification are more path dependent than is frequently acknowledged. They also highlight the importance of national institutions that have shaped professional development and differences in the way reforms have been implemented in each country for explaining variation. Author Affiliation: (1)Leeds University Business School, University of Leeds (2)Department of Economics, Politics and Public Administration, Aalborg University, Denmark (3)School of Health, Staffordshire University (4)Centre for Innovation in Health Management, University of Leeds Article note: Address for correspondence: Ian Kirkpatrick, Leeds University Business School, Maurice Keyworth Building, University of Leeds, Leeds LS2 9JT, e-mail: ik@lubs.leeds.ac.uk

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9299.2007.00630.x Byline: MIKE DENT (1), NICOLETTE VAN GESTEL (2), CHRISTINE TEELKEN (2) Abstract: This symposium grew out of the sub-theme, 'New Modes of Governance in Public Sector Organizations', of the European Group for Organizational Studies (EGOS) Conference held in Ljubljana in July 2004. Our aim was to provide a forum to discuss the policy and practice and the space between in public sector management and governance within Europe. Author Affiliation: (1)Mike Dent is Professor of Health Care Organisation in the Faculty of Health and Sciences, Staffordshire University. (2)Nicolette Van Gestel and Christine Teelken are in the Nijmegen School of Management, Radboud University, Nijmegen.

Until 2004, all confirmed cases of tick-borne spotted fever in North, Central, and South America were attributed to 1 pathogen, Rickettsia rickettsii, the cause of Rocky Mountain spotted fever. Historically, [...]

The National Health Service in Britain has recently undergone a major reorganization. It has moved away from being a planned system of health care delivery to a demand driven system organized on the principles of (quasi-) market competition and quality assurance. These changes are intended by government to 'empower' the consumer (patient) with real choice and to incorporate the health professionals within a more effective and efficient system of hospital management. It is in this context that the paper examines the usefulness of 'postmodernity' as an explanation for the emergence of new 'flexible' organizational forms within the hospital service. The paper will concentrate on the ideological and organizational contradictions between state policy and local practice, especially in relation to issues of managerial vs. professional autonomy and control. (Reprinted by permission of the publisher.), Introduction This article addresses the question of the utility of postmodernism for either the analysis or understanding of contemporary organizational restructuring. Specifically, the article examines whether the new organizational arrangements, [...]

This article examines the degree to which doctors, as members of an autonomous profession, function as organic intellectuals within capitalist society (Abercrombie and Urry, 1983) and, more generally, the complex and ambivalent relations that sustain their role within a 'service class'. It is in this context that the organization of medical care and its delivery in Britain will be addressed. In particular, the current and intended changes in the organization and control of hospital medicine within the NHS, notably the issues of medical audit, clinical budgeting and the role of the 'internal market'.