Strategic Management, Leadership and Organizational
Change – Learning Goals Week 2 + Lecture Gifford and
Empson
1. What is:
a.What is Professionalism? What are the core characteristics of a profession(alism)?
Professionalism: the occupational control of work (which is logically and empirically distinct from
consumer control and managerial control). That what should be performed for a specific profession.
The profession controls the work that is done, not the organization. Being part of a profession
influences your behaviour. It is about legitimacy; becoming officially recognized; it does not have to
be real but it is also about the practice, what other think. suggest an ideal typical model of the
institutions that sustain such control.
Professionals are influenced by institutions and this forms the behaviour in organizations and
how professionals act.
Professionalism institutionalizes professionals
Professionalism creates a closed social system, is self-controlling and is developed based on:
o Autonomy
o Quality
o Convergent thinking (stay within the box): professionals focus on staying within the context
of procedures, otherwise they violate normative pressure
Professionals are part of a profession. The core characteristics are:
1. Main resource of a profession
Knowledge
Skill
2. Commitment to service
3. Intra- or interprofessional work
Jurisdictional claims (ability of a profession to lay claim depends on power and status (1),
professional boundaries (2) and contests for professional territory (3)
Observing, defending and expanding boundaries
Based on differences in identities and core beliefs
4. Institutional constants (see next page)
The ‘’perfect’’ profession
5. Institutional variables (see next page)
Boundary conditions of professions
The strength of a profession depends on institutional constants and variables. But on the other hand,
professions can also influence institutions. A profession with more characteristics is stronger than
another one
Constants: define professionalism; a process of becoming a professional
1. An officially recognized work: do something that requires skills (e.g. surgeon); specialized work
2. An occupationally division of labour: determining what falls in and outside the profession, strict
protocols, relationships with different divisions. Defined boundaries between themselves and other
occupations; what a professional should and should not do and you have to work together (relations)
1
, 3. An occupationally controlled labour market: based on credentials/ licenses and quality. You cannot
hire anyone to be a doctor but you have to have a ‘’labour market shelter’’: requirements of a
profession to enter the labour market
4. Professional schooling: external education. Defines a profession from another job; senior doctors
teach senior doctors
Variables: the interacting contingencies (=unforeseen factors) of the process of professionalism
1. State variations: there may be differences between countries (e.g. someone from another country
may not be allowed to be a doctor in the Netherlands). The state has the power to create or maintain
a certain profession. This depends on the way the state is organized (hierarchical/coordinative) and
exercises power (reactive/active).
2. Ideologies and values: standardization of skills, culture in an organization. Professional boundaries
can change over time. Types of ideologies are managerialism, generalization and specialization
3. Variation in knowledge and skills: these differ among professionals
Vocational and on-the-job training
· Vocational training: The labor market brings the strategic importance of vocational training for
professionalism. Vocational training is the key to occupational control of both its place in its division
of labor and its labor market. Furthermore, it is the institutional key to distinguishing between craft
and professional modes of occupational control.
· On-the-job training: The craft method of controlling vocational training typically takes place
within the labor market. It is carried out as on-the-job training in the ordinary places where
members of the craft work. In contrast, professional training takes place outside the labor market, in
classrooms and, sometimes, practice settings, both segregated from ordinary workplaces.
The difference between the two has its most important outcome in the creation and extension of
the profession's corpus of knowledge and skill.
What implications does this (characteristics) have for (managing) healthcare organizations?
Professional organizations: organizations has specific checks in place ‘’on how things need to be
done’’. So basically everything is standardized (for everything, there is a procedure). Therefore,
managerial and leadership problems can exists in professional organizations (see b ii)
–Due to their own authority they are prone to resist responsibility of new task and not willing to
participate outside of their profession
–Due to specialization they might be defensive towards adding work or risks to their already existing
roster. This is because they do not know which effect this will have and if they are able to threat it
–There are boundaries between professions and this could lead to go-between between two
specializations. Due to the lack of overlap.
–The intra-professional boundary-drawing 🡪 claiming that some tasks are above or below their level.
Therefore, they will not do the job because it could harm their status. Due to this, they stated that is
should be assigned towards another profession.
Pigeonhole process: Thinking inside the box instead of outside. The organization seeks to match
predetermined contingency to a standardized program and organize itself around the skills and
knowledge of its professionals. Due to standardized procedures, you might not choose an out of the
box option (and just follow traditional recipe). This will put processes and patients into boxes.
However, for specific situations (disease that does not happen for certain age/gender) sometimes it
would be better do think outside of the box and to come out of ‘’ the pigeonhole’’.
2
Change – Learning Goals Week 2 + Lecture Gifford and
Empson
1. What is:
a.What is Professionalism? What are the core characteristics of a profession(alism)?
Professionalism: the occupational control of work (which is logically and empirically distinct from
consumer control and managerial control). That what should be performed for a specific profession.
The profession controls the work that is done, not the organization. Being part of a profession
influences your behaviour. It is about legitimacy; becoming officially recognized; it does not have to
be real but it is also about the practice, what other think. suggest an ideal typical model of the
institutions that sustain such control.
Professionals are influenced by institutions and this forms the behaviour in organizations and
how professionals act.
Professionalism institutionalizes professionals
Professionalism creates a closed social system, is self-controlling and is developed based on:
o Autonomy
o Quality
o Convergent thinking (stay within the box): professionals focus on staying within the context
of procedures, otherwise they violate normative pressure
Professionals are part of a profession. The core characteristics are:
1. Main resource of a profession
Knowledge
Skill
2. Commitment to service
3. Intra- or interprofessional work
Jurisdictional claims (ability of a profession to lay claim depends on power and status (1),
professional boundaries (2) and contests for professional territory (3)
Observing, defending and expanding boundaries
Based on differences in identities and core beliefs
4. Institutional constants (see next page)
The ‘’perfect’’ profession
5. Institutional variables (see next page)
Boundary conditions of professions
The strength of a profession depends on institutional constants and variables. But on the other hand,
professions can also influence institutions. A profession with more characteristics is stronger than
another one
Constants: define professionalism; a process of becoming a professional
1. An officially recognized work: do something that requires skills (e.g. surgeon); specialized work
2. An occupationally division of labour: determining what falls in and outside the profession, strict
protocols, relationships with different divisions. Defined boundaries between themselves and other
occupations; what a professional should and should not do and you have to work together (relations)
1
, 3. An occupationally controlled labour market: based on credentials/ licenses and quality. You cannot
hire anyone to be a doctor but you have to have a ‘’labour market shelter’’: requirements of a
profession to enter the labour market
4. Professional schooling: external education. Defines a profession from another job; senior doctors
teach senior doctors
Variables: the interacting contingencies (=unforeseen factors) of the process of professionalism
1. State variations: there may be differences between countries (e.g. someone from another country
may not be allowed to be a doctor in the Netherlands). The state has the power to create or maintain
a certain profession. This depends on the way the state is organized (hierarchical/coordinative) and
exercises power (reactive/active).
2. Ideologies and values: standardization of skills, culture in an organization. Professional boundaries
can change over time. Types of ideologies are managerialism, generalization and specialization
3. Variation in knowledge and skills: these differ among professionals
Vocational and on-the-job training
· Vocational training: The labor market brings the strategic importance of vocational training for
professionalism. Vocational training is the key to occupational control of both its place in its division
of labor and its labor market. Furthermore, it is the institutional key to distinguishing between craft
and professional modes of occupational control.
· On-the-job training: The craft method of controlling vocational training typically takes place
within the labor market. It is carried out as on-the-job training in the ordinary places where
members of the craft work. In contrast, professional training takes place outside the labor market, in
classrooms and, sometimes, practice settings, both segregated from ordinary workplaces.
The difference between the two has its most important outcome in the creation and extension of
the profession's corpus of knowledge and skill.
What implications does this (characteristics) have for (managing) healthcare organizations?
Professional organizations: organizations has specific checks in place ‘’on how things need to be
done’’. So basically everything is standardized (for everything, there is a procedure). Therefore,
managerial and leadership problems can exists in professional organizations (see b ii)
–Due to their own authority they are prone to resist responsibility of new task and not willing to
participate outside of their profession
–Due to specialization they might be defensive towards adding work or risks to their already existing
roster. This is because they do not know which effect this will have and if they are able to threat it
–There are boundaries between professions and this could lead to go-between between two
specializations. Due to the lack of overlap.
–The intra-professional boundary-drawing 🡪 claiming that some tasks are above or below their level.
Therefore, they will not do the job because it could harm their status. Due to this, they stated that is
should be assigned towards another profession.
Pigeonhole process: Thinking inside the box instead of outside. The organization seeks to match
predetermined contingency to a standardized program and organize itself around the skills and
knowledge of its professionals. Due to standardized procedures, you might not choose an out of the
box option (and just follow traditional recipe). This will put processes and patients into boxes.
However, for specific situations (disease that does not happen for certain age/gender) sometimes it
would be better do think outside of the box and to come out of ‘’ the pigeonhole’’.
2
