In Need of Renewal Rather Than Reconciliation: Why We Cannot Be Satisfied With Hospital Management’s Status Quo; Comment on “Dual Agency in Hospitals: What Strategies Do Managers and Physicians Apply to Reconcile Dilemmas Between Clinical and Economic Considerations?”

Document Type : Commentary

Author

Department of Health Sciences, Fulda University of Applied Sciences, Fulda, Germany

Abstract

Activity-based payment systems enforce Israeli and German hospital professionals to continuously balance clinical and economic considerations. As argued this status quo is unsatisfactory due to two reasons. First, professional hybridity in hospital management is restricted to the physician versus manager dichotomy rather than a multifaceted-identity framework. Second, by depending mostly on serendipity rather than hospital professionals’ organizational leeway applied reconciliation strategies seem extremely temporarily and brittle. As concluded, alternative models of hospital funding and organization such as global budgets are urgently needed. In addition, hospital professionals have to be empowered to make effectively us from their hybrid identities.

Keywords

  • epublished Author Accepted Version: February 19, 2022
  • epublished Final Version: March 13, 2022

References

  1. Waitzberg R, Gottlieb N, Quentin W, Busse R, Greenberg D. Dual agency in hospitals: what strategies do managers and physicians apply to reconcile dilemmas between clinical and economic considerations? Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.87
  2. Noordegraaf M. Hybrid professionalism and beyond: (New) forms of public professionalism in changing organizational and societal contexts. J Prof Organ. 2015;2(2):187-206. doi:1093/jpo/jov002
  3. Ewert B. Focusing on quality care rather than ‘checking boxes’: how to exit the labyrinth of multiple accountabilities in hybrid healthcare arrangements. Public Adm. 2020;98(2):308-324. doi:1111/padm.12556
  4. Martin G, Bushfield S, Siebert S, Howieson B. Changing logics in healthcare and their effects on the identity motives and identity work of doctors. Organ Stud. 2021;42(9):1477-1499. doi:1177/0170840619895871
  5. McGivern G, Currie G, Ferlie E, Fitzgerald L, Waring J. Hybrid manager–professionals' identity work: the maintenance and hybridization of medical professionalism in managerial contexts. Public Adm. 2015;93(2):412-432. doi:1111/padm.12119
  6. Sartirana M. Beyond hybrid professionals: evidence from the hospital sector. BMC Health Serv Res. 2019;19(1):634. doi:1186/s12913-019-4442-1
  7. Neby S, Lægreid P, Mattei P, Feiler T. Bending the rules to play the game: accountability, DRG and waiting list scandals in Norway and Germany. Eur Policy Anal. 2015;1(1):127-148. doi:18278/epa.1.1.9
  8. Burau V, Dahl HM, Jensen LG, Lou S. Beyond activity based funding. An experiment in Denmark. Health Policy. 2018;122(7):714-721. doi:1016/j.healthpol.2018.04.007
  9. Sørensen ML, Burau V. Why we need to move beyond diagnosis-related groups and how we might do so. J Health Serv Res Policy. 2016;21(1):64-66. doi:1177/1355819615586444
  10. Chinitz DP, Rodwin VG. On Health Policy and Management (HPAM): mind the theory-policy-practice gap. Int J Health Policy Manag. 2014;3(7):361-363. doi:15171/ijhpm.2014.122
  11. Hannah M. Humanising Healthcare: Patterns of Hope for a System Under Strain. Devon: Triarchy Press; 2014.
International Journal of Health Policy and Management
Volume 11, Issue 10
October 2022
Pages 2340-2342

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History

  • Receive Date: 14 October 2021
  • Revise Date: 10 February 2022
  • Accept Date: 16 February 2022
  • First Publish Date: 19 February 2022

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