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A psychiatrist in a bureaucracy: the unsettling compromises
Hospital & Community Psychiatry
|September 1, 1976
Summary
Psychiatrists in bureaucracies face role conflicts. They adapt by aligning with organizational views, compartmentalizing roles, or rejecting military identity to balance professional ethics and institutional demands.
Area of Science:
- Psychiatry
- Organizational Psychology
- Sociology of Professions
Background:
- Psychiatrists in bureaucratic settings navigate complex demands.
- Balancing patient-centered care with organizational expectations presents challenges.
Purpose of the Study:
- To explore how psychiatrists adapt to bureaucratic pressures.
- To understand the compromises made by military psychiatrists.
Main Methods:
- Qualitative study of nine psychiatrists in the U.S. Army.
- Observation over a two-year period in the mid-1970s.
Main Results:
- Three adaptation strategies identified: alignment with Army views, role compartmentalization, or rejection of military identity.
- Adaptation involved reconciling organizational aims, superior expectations, and the traditional therapist role.
Conclusions:
- Bureaucratic employment necessitates significant compromises for psychiatrists.
- Individual adaptation strategies vary, reflecting the tension between professional ideals and organizational realities.