GW4004MV – Organisational Behaviour
Teacher
Martina Buljac ()
Jeroen van Wijngaarden
Lecture: Fridays 11.00 – 12.45
Workgroup: 5
Teacher: Mathilde Strating
Important!
, / 2025
Lecture 1
Professionals
Organizational behaviour = the study of individuals and their
behaviour within the context of the organization in a
workplace setting. It is an interdisciplinary field that includes
sociology, psychology, and management.
- But clearer: a field of study that investigates the
impact that individuals, groups, and
structure have on behaviour within organizations, for
the purpose of applying such knowledge toward
improving an organization’s effectiveness.
- Explain and predict human behaviour by replacing
intuitive explanations with systematic study.
- Educated view.
- Not straightforward, multiple views.
Increasing pressures.
- Social cultural pressures (ageing, changing expectations, multimorbidity, rise in
noncommunicable diseases).
- Financial-economic pressures (budget cuts).
- Technological pressures (AI).
- Public- and political turmoil (always conversations about the costs of healthcare).
Trends.
- From mono- to multidisciplinary practices.
- From supply centered to client centered (parenting in providing care).
- From intramural to extramural services (more at-home services, changing how professionals
work).
- From single organisations and practices to networks (all HCPs are involved in several
networks).
--> towards holistic and integrated service delivery (horizontal and vertical integration).
Dimensions of professionalism.
1. Expertise.
2. Authority.
3. Autonomy.
Unique expertise.
- Professionalism is about applying general, scientific knowledge to specific cases (see Abbott,
1988; Elliott, 1972; Freidson, 1994, 2001).
- Complex knowledge, scientific.
- Both explicit and tacit (=from personal experience) knowledge.
o Doctors have a lot of tacit knowledge which is why we give them a lot of autonomy.
o Explicit knowledge = put on paper, describe. Implicit/tacit = based on experience but
transferrable (e.g. doctor being able to do stuff based on experience; how much
pressure to put on a vein).
, - Functional knowledge, reflective skills: they are able to teach themselves, change their
practice if required.
- Beneficial for society: HCP do stuff relevant for society.
Authority.
- Legitimate power (as a result, we expect them to perform and make choices for us).
- People trust physicians with power, based on their expertise and because this trust is
embedded in legal institutions (quality controlled, training, professional organisations
monitored).
- Based on knowledge.
- Based on legal, organisational, professional, personal status.
- Unquestioned?
o Seems to be changing now with more access to internet and AI.
Professionalism as controlled content (autonomy).
- About organizing labour.
- Task.
- Function (combination of tasks that is quite stable over time).
- Occupation (the organization doesn’t determine your tasks, you have a specific occupation
with specific tasks).
- Profession (organization has even less decision power, they hire the professional, who has to
deliver quality, but is independent in their tasks and determines what they do themselves –
much more autonomy).
- Freidson: a profession is a special status in the division of labour that is supported by an
official and sometimes public belief that it is worthy of that status.
o Not everyone can become a professional, people get that status because they
provide a public service.
Professional autonomy.
- It could refer to the individual or the group.
o It has two components: liberty (freedom to act independently) and agency (you
have the capability and are self-reflective).
o This combination makes you a professional.
- According to Beauchamp and Childress (10), ‘virtually all theories of autonomy view two
conditions as essential for autonomy: liberty (independence from controlling influences) and
agency (capacity for intentional action).
- So it is about the privilege and ability of self-governance.
- The quality and state of being independent and self-directing, especially in decision making,
enabling professionals to exercise judgement as they see fit during the performance of their
job.
- Both individually and as a collective group.
Types of autonomy.
- Political autonomy.
o Many professionals have power in deciding which budget, type of care, etc.
o Professionals have political power!
- Economical autonomy.
o Decide which fees to ask.
- Clinical autonomy (CORE!).
o Focussed on the process.
Decide how you cooperate, how the care is delivered.
, o Focussed on content (professional discretion) – REAL core.
What kind of care will you give based on circumstances of this patient?
Different views on (classic) professionalism (Martimianakis et al.).
1. A list of traits and behaviours.
2. As a role played in society (functionalism).
3. As a social construction.
4. As means and effect of social control (critical studies).
1. Professionalism as a list of traits and behaviours.
- Of the profession (organized professional group that):
o Defines standards of training.
o Criteria of competence.
o Quality criteria.
o A code of ethic.
o Has exclusive rights to perform certain tasks.
o A lot of autonomy!
- Of a professional.
o Specialised knowledge.
o Altruistic.
o Reflexivity.
o Also has autonomy, but by grace of a professional group as they uphold the criteria
and grace of that professional group.
2. Professionalism as a role played in society (functionalism).
- Reasoning about why these professional characteristics are here.
- Professionals have certain traits and behaviours because of the function they have for the
society.
- They have a lot of tacit knowledge that we cannot control, so we have to give them trust.
But trust is not unlimited, also task of professional group that they do self-control.
- Professionals are expected to act in the public interest, have a unique role.
- Because of this important function they have certain rights (self regulation); social contract
based on trust.
- Trust versus control.
- Self control: we expect them to make guidelines, but implicit knowledge now becomes
explicit and open for those who are not part of it.
- Self control --> standards --> being controlled by others.
o Consistent debate!
According to the Dutch society of specialists:
- Medical professionality:
o The values, behaviours and relationships with the society that support and justifies
the trust people have in doctors.
o Trust based contract, forms basis of social contract (implicit contract in which we say
you have a large amount of autonomy because we cannot control you and think you
provide us with a lot of value).
- Medical professionality:
o Forms the foundation of the social contract between the professional group and the
society.
Teacher
Martina Buljac ()
Jeroen van Wijngaarden
Lecture: Fridays 11.00 – 12.45
Workgroup: 5
Teacher: Mathilde Strating
Important!
, / 2025
Lecture 1
Professionals
Organizational behaviour = the study of individuals and their
behaviour within the context of the organization in a
workplace setting. It is an interdisciplinary field that includes
sociology, psychology, and management.
- But clearer: a field of study that investigates the
impact that individuals, groups, and
structure have on behaviour within organizations, for
the purpose of applying such knowledge toward
improving an organization’s effectiveness.
- Explain and predict human behaviour by replacing
intuitive explanations with systematic study.
- Educated view.
- Not straightforward, multiple views.
Increasing pressures.
- Social cultural pressures (ageing, changing expectations, multimorbidity, rise in
noncommunicable diseases).
- Financial-economic pressures (budget cuts).
- Technological pressures (AI).
- Public- and political turmoil (always conversations about the costs of healthcare).
Trends.
- From mono- to multidisciplinary practices.
- From supply centered to client centered (parenting in providing care).
- From intramural to extramural services (more at-home services, changing how professionals
work).
- From single organisations and practices to networks (all HCPs are involved in several
networks).
--> towards holistic and integrated service delivery (horizontal and vertical integration).
Dimensions of professionalism.
1. Expertise.
2. Authority.
3. Autonomy.
Unique expertise.
- Professionalism is about applying general, scientific knowledge to specific cases (see Abbott,
1988; Elliott, 1972; Freidson, 1994, 2001).
- Complex knowledge, scientific.
- Both explicit and tacit (=from personal experience) knowledge.
o Doctors have a lot of tacit knowledge which is why we give them a lot of autonomy.
o Explicit knowledge = put on paper, describe. Implicit/tacit = based on experience but
transferrable (e.g. doctor being able to do stuff based on experience; how much
pressure to put on a vein).
, - Functional knowledge, reflective skills: they are able to teach themselves, change their
practice if required.
- Beneficial for society: HCP do stuff relevant for society.
Authority.
- Legitimate power (as a result, we expect them to perform and make choices for us).
- People trust physicians with power, based on their expertise and because this trust is
embedded in legal institutions (quality controlled, training, professional organisations
monitored).
- Based on knowledge.
- Based on legal, organisational, professional, personal status.
- Unquestioned?
o Seems to be changing now with more access to internet and AI.
Professionalism as controlled content (autonomy).
- About organizing labour.
- Task.
- Function (combination of tasks that is quite stable over time).
- Occupation (the organization doesn’t determine your tasks, you have a specific occupation
with specific tasks).
- Profession (organization has even less decision power, they hire the professional, who has to
deliver quality, but is independent in their tasks and determines what they do themselves –
much more autonomy).
- Freidson: a profession is a special status in the division of labour that is supported by an
official and sometimes public belief that it is worthy of that status.
o Not everyone can become a professional, people get that status because they
provide a public service.
Professional autonomy.
- It could refer to the individual or the group.
o It has two components: liberty (freedom to act independently) and agency (you
have the capability and are self-reflective).
o This combination makes you a professional.
- According to Beauchamp and Childress (10), ‘virtually all theories of autonomy view two
conditions as essential for autonomy: liberty (independence from controlling influences) and
agency (capacity for intentional action).
- So it is about the privilege and ability of self-governance.
- The quality and state of being independent and self-directing, especially in decision making,
enabling professionals to exercise judgement as they see fit during the performance of their
job.
- Both individually and as a collective group.
Types of autonomy.
- Political autonomy.
o Many professionals have power in deciding which budget, type of care, etc.
o Professionals have political power!
- Economical autonomy.
o Decide which fees to ask.
- Clinical autonomy (CORE!).
o Focussed on the process.
Decide how you cooperate, how the care is delivered.
, o Focussed on content (professional discretion) – REAL core.
What kind of care will you give based on circumstances of this patient?
Different views on (classic) professionalism (Martimianakis et al.).
1. A list of traits and behaviours.
2. As a role played in society (functionalism).
3. As a social construction.
4. As means and effect of social control (critical studies).
1. Professionalism as a list of traits and behaviours.
- Of the profession (organized professional group that):
o Defines standards of training.
o Criteria of competence.
o Quality criteria.
o A code of ethic.
o Has exclusive rights to perform certain tasks.
o A lot of autonomy!
- Of a professional.
o Specialised knowledge.
o Altruistic.
o Reflexivity.
o Also has autonomy, but by grace of a professional group as they uphold the criteria
and grace of that professional group.
2. Professionalism as a role played in society (functionalism).
- Reasoning about why these professional characteristics are here.
- Professionals have certain traits and behaviours because of the function they have for the
society.
- They have a lot of tacit knowledge that we cannot control, so we have to give them trust.
But trust is not unlimited, also task of professional group that they do self-control.
- Professionals are expected to act in the public interest, have a unique role.
- Because of this important function they have certain rights (self regulation); social contract
based on trust.
- Trust versus control.
- Self control: we expect them to make guidelines, but implicit knowledge now becomes
explicit and open for those who are not part of it.
- Self control --> standards --> being controlled by others.
o Consistent debate!
According to the Dutch society of specialists:
- Medical professionality:
o The values, behaviours and relationships with the society that support and justifies
the trust people have in doctors.
o Trust based contract, forms basis of social contract (implicit contract in which we say
you have a large amount of autonomy because we cannot control you and think you
provide us with a lot of value).
- Medical professionality:
o Forms the foundation of the social contract between the professional group and the
society.
