An empirically-based model for clinician-managers' behavioural routines

Numerous past articles, many of which consist of idealised prescriptions for success or the occasional case study or practitioner's contribution, have commented on the role of hospital clinician-managers. Prior work is circumscribed, however, in that it tends to be normative and a priori (how clinician-managers in principle should manage) rather than descriptive and a posteriori (how clinician-managers in situ do manage). In addition, it is apparent that an empirically-grounded, testable model is lacking for the way clinician-managers work. This paper sets out to balance past normative-prescriptive accounts with a descriptive-analytic one, and presents an empirically-based conceptual model of the behavioural routines of hospital clinician-managers. The model, based on multiple studies of clinician-managers' activities, conjectures five major modes of operating and four primary and five secondary pursuits. The paper advances accounts of how clinician-management work is conducted and the time frames for it, and hypothesises about clinician-managers' relationships, and how power and control is experienced and exercised. It also briefly discusses some of the implications of both the research program and the findings. However, following Popper, researchers ought to invite attempts to improve rigor through a systematic critique of their findings. Critical analysis of this work under falsification processes is consequently welcomed