Dynamics between doctors and managers in the Italian National Health Care System

Area of Science:

• Healthcare Management
• Medical Sociology
• Public Administration

Background:

• The managerialisation of healthcare systems has altered the roles and dynamics of medical professionals.
• Existing studies on doctor responses to managerialisation often lack theoretical breadth and methodological rigor.
• A comprehensive understanding requires examining interactions with public control and regulation agencies.

Purpose of the Study:

• To analyze the evolving patterns of managerialisation among doctors within the Italian National Health Service (NHS).
• To address theoretical and methodological shortcomings in current literature on doctor responses to managerialisation.
• To provide an in-depth, longitudinal case study of a national healthcare system.

Main Methods:

• Adoption of a broader analytical perspective including public control and regulation agencies.
• Utilization of a plurality of methodologies and data sources for applied research.
• Longitudinal analysis of changes from the inception of managerialisation to the present day within the Italian NHS.
• Consideration of diverse groups within the medical profession.

Main Results:

• Managerial co-optation of a small segment of Italian NHS doctors.
• A shift from strategic adaptation to widespread resistance against managerialisation by the majority of doctors.
• Emergence of restratification processes among self-employed doctors affiliated with the NHS.

Conclusions:

• The dynamics between doctors and managers in the Italian NHS are complex and multifaceted.
• Managerialisation has led to differentiated responses and outcomes across various medical professional groups.
• Further research should incorporate broader systemic factors and employ mixed-methods approaches.