Doctor’s Orders: A Grounded Theory of Physician Power Relations in the Practice of Medicine

Abstract of the DissertationDoctor’s Orders:A Grounded Theory of Physician Power Relations in the Practice of Medicine Dramatic shifts in the way healthcare and related healthcare services are delivered and managed in the United States are unfolding at an unrelenting pace. Concurrent with ongoing changes in United States’ delivery of medicine, some argue that traditional notions of power are undergoing an equally transformative shift (Mintzberg, 2015; Naím, 2013). The confluence of the emerging reconsideration of the role of power in our society and organizations along with the dramatic changes in the American healthcare system provides a fertile backdrop and context for this study of power. At the center of this transformation, the physician maintains a unique and “very special position” in the hospital setting (Freidson, 1970). This grounded research study investigates the ways in which 24 physicians in modern hospital healthcare setting (MedHealth) conceptualize their exercise of power, autonomy, and control in their day-to-day interactions in the practice of medicine. I find physicians at MedHealth chose to conceptualize their exercise of their power, autonomy and control unitarily. Physicians in all three participant groups at MedHealth (surgeons, pediatricians and others) conceptualized a significant loss of power, autonomy, and control, in the practice of medicine. Additionally, physician conceptualizations of their exercise of power, autonomy, and control in the practice of medicine are shaped and fashioned by micro, meso, and macro level interactions. I present a theoretical model in an effort to gain a richer appreciation of how physicians at MedHealth conceptualize their power, autonomy, and control (PAC). I argue a reconceptualization of their PAC is necessary given the transformative changes to the US healthcare model. Last, I offer numerous implications for theory and practice, and recommendations for areas for future research that emerged from this research project.

Author

• Callanan, Michael I

Language

• en

Keyword

• Autonomy
• Power Relations
• Power
• Mary Follett
• Physicians

Date created

• 2018

Type of Work

• Dissertation

License

• All rights reserved

Rights statement

• In Copyright

GW Unit

• Human & Organizational Learning

Degree

• Ed.D.

Advisor

• Casey, Andrea J

Committee Member(s)

• Huising, Ruthanne
• Bocchino, Joseph M

Persistent URL

•  https://scholarspace.library.gwu.edu/etd/ng451h74s