Personalisation - An Emergent Institutional Logic in Healthcare?; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

Document Type : Commentary


School of Management and Business, King’s College London, London, UK


This commentary on the recent think piece by Mannion and Exworthy reviews their core arguments, highlighting their suggestion that recent forces for personalization have emerged which may counterbalance the strong standardization wave which has been evident in many healthcare settings and systems over the last two decades. These forces for personalization can take very different forms. The commentary explores the authors’ suggestion that these themes can be fruitfully examined theoretically through an institutional logics (ILs) literature, which has recently been applied by some scholars to healthcare settings. This commentary outlines key premises of that theoretical tradition. Finally, the commentary makes suggestions for taking this IL influenced research agenda further, along with some issues to be addressed.


Main Subjects

  1. Mannion, R., and Exworthy, M. ‘(Re) Making the procrustean bed? Standardisation and customization as competing logics in healthcare.  Int J Health Policy Manag. 2017;6(6):301-304. doi: 10.15171/ijhpm.2017.35
  2. Thornton P, Ocasio W. Institutional logics and the historical contingency of power in organizations: executive succession in the higher education publishing industry, 1958–1990. Am J Soc. 1998;105(3):801-843.
  3. Power M. The Audit Society. Oxford: Oxford University Press; 1997.
  4. Newman J, Clarke J. Publics, Politics and Power. London: Sage, 2009.
  5. Rose N. Powers of Freedom. Cambridge: Cambridge University Press; 1999.
  6. Reay T, Hinings CR.  Managing the rivalry of competing institutional logics. Organ Stud. 2009;30(6):629-652.
  7. Currie G, Spyridonidis D.  Interpretation of multiple institutional logics on the ground: Actors’ position, their agency and situational constraints in professionalized contexts. Organ Stud. 2016;37(1):77-97. doi:10.1177/0170840615604503
  8. Scott WR, Ruef M, Mendel P, Caronna C.  Institutional Change and Healthcare Organizations: From Professional Dominance to Managed Care. Chicago: University of Chicago Press; 2000.
  9. Meyer JW, Rowan B. Institutionalized organizations: formal structure as myth and ceremony. American Journal of Sociology. 1977;83(2):340-363.
  10. DiMaggio P, Powell WW. The iron cage revisited: collective rationality and institutional isomorphism in organizational fields. Am Sociol Rev. 1983;48(2):147-160
  11. Porter M. Competitive Strategy. New York: Free Press; 1980.
  12. Ferlie E, Ledger J, Dopson S, et al. The political economy of management knowledge: management texts in English healthcare organizations.  Public Adm. 2016;94(1):185-203. doi:10.1111/padm.12221
  13. Greenwood R, Hinings CR. Understanding strategic change: the contribution of archetypes. Acad Manage J. 1993;36(5):1052-1081.
  14. Kuhn, T. The Structure of Scientific Revolutions. Chicago: University of Chicago Press; 1962.
  15. Besharov ML, Smith WK. Multiple institutional logics in organizations: explaining their varied nature and implications.  Acad Manage Rev. 2014;39(3):364-381. doi:10.5465/amr.2011.0431.
  16. Binder A.  For love and money: Organizations’ creative responses to multiple environmental logics. Theor Soc.2007;36(6):547-571. doi:10.1007/s11186-007-9045-x
  17. Denis JL, Ferlie E, Van Gestel N.  Understanding hybridity in public organizations. Public Adm. 2015;93(2):273-289.
  18. Spitzmueller MC. Shifting practices of recovery under community mental health reform: A street-level organizational ethnography. Qual Soc Work. 2014;13(1):26-48.
  19. Thornton PH, Ocasio W, Lounsbury M. The institutional logics perspective: a new approach to culture, structure, and process. Oxford: Oxford University Press; 2012.
  20. Scott WR. Lords of the dance: professionals as institutional agents. Organ Stud. 2008;29(2):219-238.