Motivation og identitet hos de nye ledende overlæger

Abstract

The latest collective agreement in 2021 changed the medical management positions in Danish hospitals, introducing a middle management position of leading consultant physician (ledende overlæge). The new structure aims to strengthen medical management and allow chief physicians (cheflæger) to delegate management tasks. However, the new role can be perceived as conflictual, and in some areas in conflict with professional autonomy. The thesis examines the challenges that leading consultants experience in relation to their motivation and identity as physicians and managers, through semi-structured interviews with a total of eight physicians at different management levels from two different hospital departments. The theoretical perspectives are public service motivation, hybrid leadership identity and social identity.
The thesis concludes that the leading consultants interviewed generally experience a good match between their clinical function and their management function. With the current content of the position, they experience good opportunities to fulfil their motivation and a good balance in their identity as a doctor and a leader, both socially in relation to their medical colleagues and in relation to their self-identity as hybrid leaders. However, both motivation and identity can be challenged if and when leading consultants have to engage in more conflictual management dimensions such as prioritisation of tasks and resources and especially formal staff management. Staff management can be particularly difficult for senior consultants with strong professional norms about professionalism as the basis for managerial authority. The leading consultants are aware that they are in the process of a development that over time will create the necessary distance from the rest of the medical group, albeit with mixed feelings. In the further development, it is crucial for the leading consultants that they have good support from their management network, where the relationship with the chief physician is central. This will provide a good basis for future leading consultants who are willing to take on hybrid leadership and grow in it through identity work.