DOCTORS AS MANAGERS - New Public Management in a New Zealand hospital
研究新西兰一家公立医院引入“临床领导力”策略，让医生兼任管理者，分析他们如何在专业与管理角色间平衡，以及多数医生如何吸收变革而非主动推动变革。
Abstract In a corporatized New Zealand public hospital, senior management introduced a strategy of ‘clinical leadership’ intended to incorporate clinicians more fully within some system of organizational control, and to make them accountable for the resources consumed as a consequence of their treatment decisions. An organizational restructuring created semiautonomous business units based around clinical specialities and headed by clinician managers. Clinician managers played a boundary role between their professional colleagues and management. In the short term, a number of senior clinicians adapted to this role and there was some evidence for their acculturation into managerial identifications. However, the majority of clinician managers acted to absorb change rather than actively champion change. For many clinical units, clinical practice continued more or less unchanged. The concept of loosely coupled systems is used to explain this separation of internal operations from organizational form. Keywords: New Public Management Organizational Change Loose Coupling Clinician Managers Health Reform