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Etre ou ne pas être mèdecin-gestionnaire ? : étude de la transition vers le rôle de responsable de pôle dans les hôpitaux publics français

Abstract : How can a doctor become a doctor-manager? Can a doctor even become a doctor-manager? This dissertation aims at better understanding the phenomenon of transition from a regular doctor role to a doctor-manager role, a transition that is experienced as difficult in practice and theory. This phenomenon tends to be developed with the spread of performance management within European public organizations. This research draws upon the example of the clinical director role, a new role in French public hospitals that is mixing both medical and managerial responsibilities. This dissertation is based on three progressive studies. A first study examines this transition with a global view by analyzing the adjustments between a doctor and his/her new role. It is carried out through a case study within two health care organizations (a teaching hospital and a hospital) and through interviews with their 22 clinical directors. This study shows the importance of the individual dimension for the transition to succeed. A second study focuses on the influence of role identification on the way a doctor-manager role is enacted. A case study and interviews with 4 clinical directors and their main colleagues within a teaching hospital are used to reach this goal. This study reveals the customization effect of identification on a doctor-manager role. A third and last study deeply focuses on the identity work of doctors in their enactment of a doctor-manager role. We address this issue by using a case study with the same 4 clinical directors, but through direct observations of their behavior during meetings. This study shows the importance of activating of identity into the context to enact a doctor-manager role. Finally, our main argument in this dissertation is that a transition to a doctor-manager role can be lead through various adjustments and identification situations, as long as identity is reworked during role enactment. We suggest to hospital directors to give priority to the use of field management tools oriented on personalization, in order to help doctors understand the logic of their roles.
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Submitted on : Tuesday, November 20, 2012 - 11:17:18 AM
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Franck Burellier. Etre ou ne pas être mèdecin-gestionnaire ? : étude de la transition vers le rôle de responsable de pôle dans les hôpitaux publics français. Gestion et management. Université de Grenoble, 2011. Français. ⟨NNT : 2011GRENG013⟩. ⟨tel-00754966⟩



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