Purpose: To improve health-care delivery from within, managers need to engage physicians in organisational development work. Physicians and managers have different mindsets/professional identities which hinder effective communication. The aim of this paper is to explore how managers can transform this situation.
Design/methodology/approach: The authors' interview study reveals physicians' own perspective on engagement for organisational improvement. They discuss identities from three theoretical perspectives and explore the mindsets of physicians and managers. They also explore the need to modify professional identities and how this can be achieved.
Findings: If managers want physicians to engage in improvements, they must learn to understand and appreciate physician identity. This might challenge managers' identity. The paper shows how managers - primarily in a Swedish context - could act to facilitate physician engagement. This in turn might challenge physician identity.
Research limitations/implications: Studies from the western world show a coherent picture of professional identities, despite structural differences in national health-care systems. The paper argues, therefore, that the results can be relevant to many other health-care systems and settings.
Originality/value: The paper provides an alternative to the prevailing managerial control perspective. The alternative is simple, yet complex and challenging, and as the authors understand it, necessary for health care to evolve, from within.