Dissertation/Thesis Abstract

Doctor's Orders: A Grounded Theory of Physician Power Relations in the Practice of Medicine
by Callanan, Michael I., Ed.D., The George Washington University, 2018, 347; 10748433
Abstract (Summary)

Dramatic shifts in the way healthcare and related healthcare services are delivered and managed in the United States are unfolding at an unrelenting pace. Concurrent with ongoing changes in United States’ delivery of medicine, some argue that traditional notions of power are undergoing an equally transformative shift (Mintzberg, 2015; Naím, 2013). The confluence of the emerging reconsideration of the role of power in our society and organizations along with the dramatic changes in the American healthcare system provides a fertile backdrop and context for this study of power.

At the center of this transformation, the physician maintains a unique and “very special position” in the hospital setting (Freidson, 1970). This grounded research study investigates the ways in which 24 physicians in modern hospital healthcare setting (MedHealth) conceptualize their exercise of power, autonomy, and control in their day-to-day interactions in the practice of medicine.

I find physicians at MedHealth chose to conceptualize their exercise of their power, autonomy and control unitarily. Physicians in all three participant groups at MedHealth (surgeons, pediatricians and others) conceptualized a significant loss of power, autonomy, and control, in the practice of medicine. Additionally, physician conceptualizations of their exercise of power, autonomy, and control in the practice of medicine are shaped and fashioned by micro, meso, and macro level interactions.

I present a theoretical model in an effort to gain a richer appreciation of how physicians at MedHealth conceptualize their power, autonomy, and control (PAC). I argue a reconceptualization of their PAC is necessary given the transformative changes to the US healthcare model. Last, I offer numerous implications for theory and practice, and recommendations for areas for future research that emerged from this research project.

Indexing (document details)
Advisor: Casey, Andrea J.
Commitee: Bocchino, Joseph M., Huising, Ruthanne
School: The George Washington University
Department: Human & Organizational Learning
School Location: United States -- District of Columbia
Source: DAI-B 79/08(E), Dissertation Abstracts International
Subjects: Medical personnel, Health care management
Keywords: Autonomy, Physicians, Power, Power relations
Publication Number: 10748433
ISBN: 9780355781939
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