Enterprise discourse, professional identity and the organizational control of hospital clinicians
Enterprise discourse, professional identity and the organizational control of hospital clinicians
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DOI：
10.1177/0170840602233003
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发表时间：
2002-01-01
影响因子：
5.4
通讯作者：
Doolin, B
中科院分区：
文献类型：
--
作者：
Doolin, B
新西兰卫生保健部门最近的改革涉及公立医院的公司化，以及机构之间和机构内部社会关系的契约化。为了使医院的临床医生对他们的治疗决定所消耗的资源负责，人们进行了各种尝试，将医院的临床医生纳入某种组织控制系统。本文认为，政府的总体意图是如何控制，削减或影响医院临床医生的专业自主权发挥了在一个单一的新西兰医院的背景下。它认为，权力影响的话语与这种新自由主义的改革方案可能会影响医院临床医生的主观性，调整他们的临床行为与政府计划的更广泛的目标。它探讨了个人如何操纵有关这些话语的管理和企业，无论是在接受，抵制或妥协。由此产生的结果是复杂和多样的，因为个人在身份和自我的构建中谈判占主导地位的话语。
Recent reform of the healthcare sector in New Zealand involved the corporatization of public hospitals, and the contractualization of social relations between and within institutions. Various attempts were made to incorporate hospital clinicians within some system of organizational control in order to make them accountable for the resources consumed as a consequence of their treatment decisions. This paper considers how the general intention of government to control, curtail or influence the professional autonomy of hospital clinicians was played out in the context of a single New Zealand hospital. It considers the possibility that power effects of discourses associated with such neo-liberal programmes of reform could influence the subjectivity of hospital clinicians, aligning their clinical behaviour with the broader goals of the governmental programme. It explores how individuals manoeuvre in relation to these discourses of management and enterprise, whether in acceptance, resistance or compromise. The resulting outcomes are complex and varied, as individuals negotiate dominant discourses in the construction of identity and self.