How Managerial Measures can Influence Professionalism and the Other Way Around? An Inquiry Into the Implementation of an Online Patient Administrative Platform at a Norwegian Hospital Department

Karen Egge

Student thesis: Master thesis


During the past 20 years, there has been an unrest dominating health care sectors in many of the western countries, and the mindset behind it is often referred to as New Public Management (NPM), and the managerialisation of hospitals. Governmental reform initiatives, restructuring efforts are all examples that reflect an increased need for cost control and efficiency, which is a respond to societal encounters such as increased populations, life expectancy, and medical advances. The entrance of managerialism into a professional environment such as a hospital is subject to many studies and discussions. Theoretically, the two mindset professionalism and managerialism are proven contradictory, but less is known about how actual physical changes to professionals department, imposed on them by managerialism might interfere with professional practice. Typical traits or values of professionalism that is said to be challenged by managerialism are often referred to as prerogatives, or privileges, that is attempted to be taken away by managerial measures. This implies a focus that is perhaps not fruitful, in the sense that one discusses whether or not the professionals should be allowed to keep their prerogatives, but the question of how these prerogatives influences their professional practice, and to what degree the consequences would be crucial for quality of their services, is undermined. The call for this thesis, is to take a more concrete approach, trying to demystify the interplay between managerialism and professionalism, in order to get closer to detecting how managerial measures can influence professional practice, and further what consequences this will have for their professionalism when making decisions on behalf of patients. By employing a conceptual framework, based on sociology of professions, managerialism and existing health service research, to a qualitative case study at a Norwegian hospital, it was possible to detect which dimensions of professionals’ workday that was altered after the implementation of a new online patient administrative platform, and how this was perceived by professionals to interfere with their professional practice. Evidences in this thesis suggests that by imposing managerial measures that assumes control over how professionals spend their time, and balances time between core and support tasks, the measures seem to affect professionalism. However, such changes are too invasive of professionalism, so that professionals will resist the changes, indicating that professionalism might also affect managerialism. During the interviews, it also became evident that even though the managerial measures were the same, the degree to which it was embedded in the departments might vary. It is therefor suggested that further research is done in other departments, to see if their professional practice is altered to a degree that is in conflict with their professional commitment.

EducationsMSc in Strategy, Organization and Leadership, (Graduate Programme) Final Thesis
Publication date2016
Number of pages99