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New Zealand pathologists: a case study in occupational control.

N France1, S Lawrence, J F Smith

  • 1Faculty of Arts and Social Sciences, Waikato Management School, University of Waikato, Hamilton, New Zealand.

Journal of Management in Medicine
|June 16, 2001
PubMed
Summary

New Zealand

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Area of Science:

  • Health management
  • Medical practice
  • Public health policy

Background:

  • The 1990s New Public Management reforms in New Zealand aimed to increase efficiency in public services.
  • These reforms introduced external managerial controls into healthcare settings, including pathology services.
  • Pathologists experienced a shift in decision-making power from professional autonomy to external management.

Purpose of the Study:

  • To examine the impact of New Public Management reforms on the managerial control of New Zealand pathologists.
  • To analyze the changing dynamics of professionalism and resource allocation in pathology services.
  • To investigate the consequences of shifting decision-making power from pathologists to external management.

Main Methods:

  • Analysis of archived data and interviews conducted between 1997 and 2000.
  • Examination of the influence of bureaucratic and free-market controls on pathology practice.
  • Discussion of professionalism perspectives in relation to resource management.

Main Results:

  • External managerial control over pathologists increased significantly during the 1990s reforms.
  • The implementation of tight bureaucratic and free-market controls risked compromises in pathology service quality.
  • A tension emerged between professional autonomy and external managerial oversight.

Conclusions:

  • The pursuit of efficiency through external controls may negatively impact healthcare quality.
  • A shift in control structures can challenge professional roles and responsibilities.
  • A health professional control model is suggested to maximize health gains.

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