This chapter aims to analyse the way the medical profession interprets and responds to the external pressures and managerial values imposed by state policies. It focuses on the actor perspective in order to highlight and discuss individual engagement in organisations as an embedded process. In Portugal, doctors' influence on state regulation seems to counter the dynamics that have been described in sociology of professions and organisations theory, which points out the growing managerial control over medical authority and the state regulation of medical procedures. Across European countries, the relation between professionalism and managerialism give place to new emergent configurations of hybrid professionals and mixed forms of governance in healthcare. The reflection on the interplaying of doctors with other health professions shows how the introduction of new public management (NPM) reforms reinforces medical domination in the social division of work in healthcare. Multi-professional cooperation in healthcare implies a commitment between an old model of governance, professional control and NPM tools.
|Title of host publication||The Transformation of Work in Welfare State Organizations|
|Subtitle of host publication||New Public Management and the Institutional Diffusion of Ideas|
|Editors||Frank Sowa, Ronald Staples, Stefan Zapfel|
|Place of Publication||Oxford|
|Number of pages||17|
|Publication status||Published - 2018|
Serra, H. (2018). Managerial doctors: Professionalism, managerialism and health reforms in Portugal. In F. Sowa, R. Staples, & S. Zapfel (Eds.), The Transformation of Work in Welfare State Organizations: New Public Management and the Institutional Diffusion of Ideas (pp. 74-91). Oxford: Routledge.