Lægesekretærens faglige profil

Michelle Guldborg Hagelberg

Student thesis: Master executive thesis


The healthcare system of the future will have higher expectations from patients, which means that an ongoing decision must be made as to where the tasks are handled best, most cost-effectively and with the greatest possible value for the patient. At the same time, the public sector is constantly evolving with new technologies and more digitalization. It has an impact on public workplaces, professions and areas of expertise. This happens by tasks that are disappearing, new tasks arising, and the requirements to the different areas of expertise are changing.
At the same time, the healthcare system is facing a period in which the recruitment of staff can be a challenge due to smaller generations of working age adults, but also due to increased pressure and lack of the right skills. In the future, the hospitals will experience more patients with chronic diseases as well as more children and elderly patients, as a result of the demographic development. It will therefore be a challenge to get enough financial resources for the tasks but will also put pressure on the working environment in the hospitals. Yet both doctors and nurses spend unnecessarily time on administrative work, thus reducing time with the patients.
As a solution to these challenges, calculations have shown that if the chief physicians use 5 percent less of their working time on administrative tasks, it will correspond to approx. 300 more chief physicians. The same calculations indicate that if the nurses in the same way, spend 5 percent less of their working time on administrative tasks, it will correspond to almost 1,800 more nurses. This administrative work can advantageously be handled by medical secretaries who are trained for it and have the right skill set for it. In the same way, an efficient operation also requires development and optimization of workflows and well-coordinated patient care pathways. Here, medical secretaries are also a great resource, especially if the areas of expertise between the professions are broken down.
With this thesis, I want to uncover what characterizes a medical secretary, and what barriers and driving forces can strengthen the medical secretary profession's position in the healthcare system of the future. There are already general studies and descriptions of the medical secretary profession, as an attempt to objectify the profession and connect it with specific tasks, however the profession is so diverse that it has not previously been possible with a complete description. Therefore, I will seek to explain how the profession and its expertise are experienced in a socially constructed world, in which I want to uncover a complex universe of meaning based on perceptions in different contexts.
This study is therefore a study of the subjective experience, where I will examine how the medical secretaries' profession and expertise are perceived and experienced in the health care system. A reality that may be ambiguous and not necessarily the same in different contexts. It is a universe of meaning, where I seek to understand similarities and differences, barriers and driving forces, both at Rigshospitalet and at Aalborg Hospital. The analysis is therefore based on a qualitative study, as I also seek to uncover the complex, and thus not an exact knowledge, but knowledge of a complex phenomenon, partly created through opinions and motives.
The study takes place by collecting data from document studies supplemented with interviews of medical secretaries and senior medical secretaries, as well as an observational study.
The result of the study shows that the medical secretary profession in many ways is characterized as a typical business profession, where they master the profession's tasks with a high degree of tacit knowledge and adapts to the organization's short-term production needs, by being flexible and mobile in relation to tasks and functions. The profession has a broad area of expertise, where the tasks are so diverse and different that the profession cannot be generalized and unambiguously recognized. For the society, the profession has a core value, which is associated with service, communication, journaling and coordination of patient care pathways. Within the organization, the medical secretaries are also experienced as having the same core value for the society but are attributed an additional core value in relation to registration of the patient cases.
For the medical secretary profession, there are no formal job descriptions and the range of skill sets are very limited, which also applies to the profession's internal career opportunities.
Overall, the profession is characterized by what is in theory called outsiders, due to their more peripheral work functions, without internal career opportunities. The culture and the dominant norms are also marked by the role of outsiders, and often also as a victim culture, which to a large extent is one of the medical secretaries' biggest barriers.
Over the years, the profession has been through a constant development, change and adaptation, which is why the profession must be seen with one, of lifelong development and learning.
When medical secretaries are not naturally considered into the professional community, the reason may be that professions with low legitimacy in relation to their service or activity are more exposed to criticism and claims that they are superfluous. But via concrete actions, the medical secretaries themselves can influence their legitimacy.
For the medical secretaries, the possibilities and the driving force therefore lies in action. By being aware of making the professions core value more visible through action and events, the environment can be manipulated to form new opinions about the profession, which will overshadow the stereotyping of the medical secretary. Reports and inspiration catalogs about the tasks of the medical secretaries are not enough, because they are not read by the relevant people. They need to experience action, and to see and feel where the medical secretaries make a difference.
Another driving force is strategic management, where the leading medical secretaries work collectively to strengthen the professional identity and professionalism, thereby increasing the organizational holistic understanding and therefore gaining access to the professional community.
The medical secretaries have a strength in that they often collaborate with many other professions and thereby have the opportunity to monitor new organizational needs and therefore be at the forefront. In the same way, the group of senior medical secretaries can establish working groups and committees that work strategically so that the profession can win, maintain and possibly repair their legitimacy.

Educations, (Graduate Programme) Final Thesis
Publication date2020
Number of pages46
SupervisorsKarina Sehested