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Updated: Feb 28, 2026

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

Published on: January 20, 2019

Pathways to Autonomy: Chinese Physicians' Responses to Clinical Pathways amid Institutional Complexity.

Lei Jin¹, Lin Tao²

¹The Chinese University of Hong Kong, Hong Kong, SAR.

Journal of Health and Social Behavior

|February 26, 2026

Summary

Physicians in China responded to standardized work tools in four ways: ignoring, coerced, decoupling, or embracing. Embracing these tools led to increased physician autonomy and job satisfaction, challenging previous research.

Keywords:

autonomy clinical pathways institutional logics professionalism rationalization

Related Experiment Videos

Last Updated: Feb 28, 2026

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion

Published on: January 20, 2019

Area of Science:

Healthcare Management
Organizational Behavior
Medical Sociology

Background:

Professionals face increasing rationalization and standardization tools in their work.
Existing research often views responses to these tools as a simple resistance-to-control spectrum.
The institutional logics perspective suggests more complex professional responses and outcomes.

Purpose of the Study:

To examine physicians' reactions to clinical pathway implementation in China.
To investigate the impact of these reactions on clinical autonomy and job satisfaction.
To broaden the conceptualization of professional responses to rationalizing tools.

Main Methods:

Survey data collected from 1,116 physicians in Chinese public hospitals.
Cluster analysis used to identify distinct physician response types to pathway implementation.
Statistical analysis to determine the impact of response types on clinical autonomy and job satisfaction.

Main Results:

Four distinct physician response types were identified: ignoring, coerced, decoupling, and embracing.
The 'embracing' group actively engaged with pathways, reporting high autonomy and satisfaction.
The 'coerced' group experienced reduced autonomy and satisfaction due to imposed pathways.
The 'ignoring' and 'decoupling' groups maintained autonomy with varying levels of engagement.

Conclusions:

Physicians' responses to rationalizing tools are diverse, not limited to resistance or control.
Active engagement ('embracing') with standardized tools can enhance both professional autonomy and job satisfaction.
Understanding these varied responses is crucial for navigating institutional complexity in healthcare settings.