Organizational constraints as root causes of role conflict

J Health Organ Manag. 2019 Mar 28;33(2):204-220. doi: 10.1108/JHOM-07-2017-0169. Epub 2019 Jan 25.

Abstract

Purpose: The purpose of this paper is to gain a better understanding of the difficulties encountered in the hybrid roles of physician-managers (P-Ms), examine the impact of organizational constraints on the role conflicts experienced by P-Ms and explore the different ways their two roles are integrated.

Design/methodology/approach: A qualitative approach was adopted, using six focus groups made up of clinical co-managers, medical directors and P-Ms. In all, 43 different people were interviewed to obtain their perceptions of the day-to-day realities of the role of the P-M. The data collected were subsequently validated.

Findings: Although the expectations of the different groups involved regarding the role of P-Ms are well understood and shared, there are significant organizational constraints affecting what P-Ms are able to do in their day-to-day activities, and these constraints can result in role conflicts for the people involved. Such constraints also affect the ways P-Ms integrate the two roles. The authors identify three role hybridization profiles.

Practical implications: The results afford a better understanding of how organizational constraints might be used as levers of organizational change to achieve a better hybridization of the dual roles of P-Ms.

Originality/value: This paper seeks to reach beyond a simple identification of constraints affecting the dual roles of P-Ms by analyzing how such constraints impact on these professionals' day-to-day activities. Results also enable us to further refine Katz and Kahn's (1966) role model, in addition to identifying hybridization profiles.

Keywords: Clinician manager; Doctor manager; Hybridization; Organizational role theory; Role expectations.

MeSH terms

  • Canada
  • Conflict, Psychological*
  • Female
  • Focus Groups
  • Hospitals, University / organization & administration*
  • Humans
  • Male
  • Organizational Innovation
  • Physician Executives / psychology*
  • Physician Executives / statistics & numerical data
  • Physicians / psychology*
  • Physicians / statistics & numerical data
  • Professional Role / psychology*
  • Qualitative Research