Surviving multiple obligations through stimulation, autonomy, and variation

J Health Organ Manag. 2011;25(4):455-68. doi: 10.1108/14777261111155056.


Purpose: Professionals in academic health centers (AMCs) face multiple obligations, such as those from research, teaching and clinical care. The purpose of this study is to explore and develop an understanding about how well findings generated from two previous studies about the influence of multiple obligations on health care personnel fit those within health care associated with academic institutions.

Design/methodology/approach: A total of 11 professionals engaged in teaching, research, and clinical work were interviewed. Data from the open-ended interactive interviews were transcribed and compared with findings from the two previous studies, using modified analytic induction.

Findings: Work at an AMC can entail balancing three tasks: research, education, and clinical care. These tasks as well as the different employers associated with them can be a source of conflict. For a group of committed professionals, these conflicts were accepted and balanced as long as they experienced stimulus, autonomy, and variation.

Research limitations/implications: Modified analytic induction, an uncommon analysis method, is useful for comparing findings from previous studies in another context and with different subjects.

Practical implications: Stimulation, autonomy, and variation could play a vital role as driving factors in coping and dealing with the unavoidable presence of multiple obligations in today's health care systems.

Originality/value: Although AMCs combine clinical care, research, and teaching, the intersection of all three has in contrast not been investigated so thoroughly at the individual level.

MeSH terms

  • Academic Medical Centers / organization & administration*
  • Adult
  • Attitude of Health Personnel*
  • Conflict, Psychological*
  • Humans
  • Internal-External Control
  • Interviews as Topic
  • Job Satisfaction
  • Middle Aged
  • Professional Autonomy*
  • Research
  • Sweden
  • Teaching
  • Workload*