Who will lead the physicians unwilling to lead? Institutional logics and double-bind situations in health care leadership
Journal article, 2016

Purpose - Health care organizations are increasingly demanded to balance the institutional logic of "medical professionalism" and "business-like health care," that is, to both recognize physicians' professional expertise while locating it in a wider social, economic, and political organizational setting. The purpose of this paper is to examine the implications from this shift in terms of leadership work in health care organizations. Design/methodology/approach - Case study methodology including interviews with 15 residents in Swedish health care organizations. Findings - A study of the willingness of residents to take on leadership positions show that leadership roles are treated as what is potentially hindering the acquisition of the know-how, skills, and expertise demanded to excel in the clinical work. Consequently, taking on leadership positions in the future was relatively unattractive for the residents. In order to overcome such perceived conflict between professional skill development and leadership roles, top management of health care organizations must help residents overcome such beliefs, or other professional groups may increasingly populate leadership positions, a scenario not fully endorsed by the community of physicians. Originality/value - The paper demonstrates how complementary or completing institutional logics are influencing debates and identities on the " shop floors" of organizations.

Health care organizations


Business & Economics


Institutional logic


Alexander Styhre

University of Gothenburg

A. Roth

J. Roth

Leadership and Organization Development Journal

0143-7739 (ISSN)

Vol. 37 3 325-340

Subject Categories

Business Administration



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