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Uncovering paradoxes from physicians’ experiences of patient-centered ward-round

Uncovering paradoxes from physicians’ experiences of patient-centered ward-round PurposeThe purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department.Design/methodology/approachAbductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings.FindingsThis paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician’s professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician’s professional identity was centered. Physicians with more of an I-perspective experienced challenges with the new round, while physicians with more of a We-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered.Practical implicationsFor change processes affecting physicians’ professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure.Originality/valueThis paper provides increased understanding about how physicians’ professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Leadership in Health Services Emerald Publishing

Uncovering paradoxes from physicians’ experiences of patient-centered ward-round

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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
1751-1879
DOI
10.1108/LHS-08-2015-0025
pmid
27198705
Publisher site
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Abstract

PurposeThe purpose of this paper is to uncover paradoxes emerging from physicians’ experiences of a patient-centered and team-based ward round, in an internal medicine department.Design/methodology/approachAbductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings.FindingsThis paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician’s professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician’s professional identity was centered. Physicians with more of an I-perspective experienced challenges with the new round, while physicians with more of a We-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered.Practical implicationsFor change processes affecting physicians’ professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure.Originality/valueThis paper provides increased understanding about how physicians’ professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.

Journal

Leadership in Health Services – Emerald Publishing

Published: Jan 1, 2016

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