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Dynamics between doctors and managers in the Italian National Health Care System
Author(s) -
Vicarelli Giovanna M.,
Pavolini Emmanuele
Publication year - 2017
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/1467-9566.12592
Subject(s) - order (exchange) , resistance (ecology) , perspective (graphical) , dynamics (music) , adaptation (eye) , field (mathematics) , control (management) , public relations , health care , service (business) , political science , sociology , psychology , business , management , marketing , law , economics , computer science , ecology , pedagogy , mathematics , finance , artificial intelligence , neuroscience , pure mathematics , biology
This article focuses on the changes in the Italian NHS by concentrating on patterns in the managerialisation of doctors. It addresses a series of shortcomings in studies on the response by doctors to managerialisation. The first is a shortcoming of theoretical and analytical nature. It is necessary to adopt a broader perspective whereby analysis considers not only the interaction between doctors and managers, but also the public control and regulation agencies that operate in that field. The second shortcoming is a methodological one. The literature on managerialisation is more theoretical than applied. It is necessary to adopt a strategy based on a plurality of methodologies and sources in order to focus attention on a national case (Italy in the present study), discussing the changes over time (from the beginning of managerialisation until today) and considering different groups within the medical profession. The outcome is a complex picture of the dynamics between doctors and managers which foregrounds the managerial co‐optation processes of a small group of national health service doctors, the transition from strategic adaptation to forms of resistance against managerialisation by the majority of Italian NHS doctors, and the emergence of restratification processes among self‐employed doctors working with the NHS .