Health systems in transition: professional identity work in the context of shifting institutional logics
Academy of Management Journal
Academy of Management
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Tracey, P., & George, G. (2017). Health systems in transition: professional identity work in the context of shifting institutional logics. Academy of Management Journal, 60 (2), 610-641. https://doi.org/10.5465/amj.2013.0684
We investigate how established professionals manage their identities in the face of identity threats from a contested shift in the professional logic that characterizes their field. To do so, we draw on interviews with 113 physicians from five European transition countries who faced pressure for change in their professional identities due to a shift in the logic of healthcare from a logic of "narrow specialism" in primary care that characterized the Soviet health system to a new logic of "generalism" that characterizes primary care in the West. We found three important forms of professional identity threats experienced by physicians during this period - professional values conflict, status loss, and social identity conflict. In addition, we identified three forms of identity work - authenticating, reframing, and cultural repositioning - that the professionals who successfully transitioned to the new identity performed in order to reconstruct their professional identities so that they were aligned with the new logic. Based on these findings, we present a model of how established professionals change their professional identities as a result of a contested shift in the professional logic of their field and discuss the underlying mechanisms through which this occurs.
The authors thank Jason Colquitt and three reviewers for their constructive guidance. Yiannis Kyratsis and Rifat Atun gratefully acknowledge their funding and support from the World Bank and the Global Fund. Gerard George acknowledges the UK’s Economic & Social Research Council Professorial Fellowship (RES-051-27-0321) and the Singapore Ministry of Education (MOE) Academic Research Fund (AcRF) Tier 1 grant.
External DOI: https://doi.org/10.5465/amj.2013.0684
This record's URL: https://www.repository.cam.ac.uk/handle/1810/253824