Summary Course GW4004MV Organisational Behaviour
Include lectures!
Week 1: Professionals
Mandatory literature:
Waring, J., & Currie, G. (2009). Managing expert knowledge: organizing challenges and
managerial futures for the UK medical profession.
Re-stratification highlights the role of professional ‘elites’ in managing change among the
‘rank and file’, for example where leaders are ‘co-opted’ into managerial roles.
Bureaucratization highlights the rationalization of work through procedural guidelines in the
form of more rule-based practices.
Echoing the idea of ‘soft bureaucracy’, these developments bring together discretionary
practice with more bureaucratic controls through ‘flexible corporatism’ and ‘objectified
subjectivity’. This hinges on fusing external (managerial) and internal (professional)
performance expectations so workers are compelled to conform to managerial expectations
as a means of securing occupational legitimacy.
Occupational and Organizational Strategies of Knowledge Management
Professional Knowledge and Autonomy
The concept of autonomy has long been used to describe the relative freedom of
professions to plan and undertake their work. Somewhat confusingly, it is often used to
explain influence in both the social organization and the technical substance of work.
- The former refers to how work is organized, including socio-legal parameters,
remuneration and client relations.
- The latter refers more narrowly to the technical application of knowledge and
experience within a given area of practice.
Professional work is rarely autonomous in an absolute sense; rather, it is bounded by various
political, legal and bureaucratic factors. In short, professionalism can be interpreted as a way
of controlling knowledge towards occupational advantage and reinforcing claims to
autonomous working whether at the institutional level, through specialist education and
licensure, or at the organizational level in day-to-day practice.
Transitions in the Management of Knowledge
Knowledge constitutes a resource that organizations seek to manage in the pursuit of
improved performance; exemplified by the application of KM systems. Although KM can take
various forms, it often resembles a top-down, technical ‘fix’ that enables managers to
harness the knowledge of employees. In general, it is associated with:
- Accumulation involves procedures for systematically gathering knowledge from
within an organization.
- Storage includes mechanisms for compiling, encoding and analysing knowledge so
that it can be shared and accessed.
- Leverage involves disseminating and applying knowledge so that improved ways of
working are achieved.
,KM enable managers to become more knowledgeable about how work is undertaken and,
through utilizing this knowledge, more able to reorder work towards competitive or
organizational advantage.
- KM provides a mechanism by which managers can acquire a degree of control over
the technical knowledge that informs work. Seen in this way, KM can be interpreted
as a significant challenge to professional jurisdiction and autonomous working.
Specifically, it enables managers to systematically ‘detach’ and make explicit the
knowledge that informs professional work.
o Incident reporting and risk analysis enable hospital risk managers to more
thoroughly gather and use the knowledge and experience of clinicians.
Although this is presented as fostering organizational learning, these systems
also enable hospital managers to codify and make explicit the experiential
knowledge of clinicians, to detach knowledge from frontline practice and to
utilize this knowledge to realign working practices. Such systems have the
potential to undermine professional autonomy as hospital managers acquire
greater scope to monitor the quality of clinical work.
- Where professionalization can be seen as a strategy for controlling knowledge
towards occupational advantage, KM signifies a strategy for controlling knowledge
towards managerial advantage.
Managing Knowledge: Blurring Boundaries
A growing body of research illustrates the need to appreciate this interplay between
managerial and professional strategies. KM has found particular salience in settings where
work is perhaps more amenable to standardization and where knowledge is more explicit
and open to codification.
We also recognized that managerial change is often contested and corrupted, particularly in
the professional setting. The reconstruction of professional work often occurs through the
mediation of both the intent to manage work from ‘above’ and the intent to resist
management from ‘below’.
Three forms of structured professional response.
- ‘co-optation’: doctors are able to capture at the local level both the legitimate
responsibility and the tangible processes for learning. Systems that were initially
centralized and anchored within management practice become decentralized and re-
anchored within medical practice, marginalizing hospital risk managers from their
own systems. Rather than doctors being co-opted into management roles, i.e. as
medical directors, this shows how management practices are co-opted into medical
roles.
- ‘adaptation’: doctors again seek to capture the systems being introduced by the
hospital’s risk managers as a means of both fostering local learning and limiting
managerial encroachment. For these doctors, techniques such as incident reporting
were regarded as unfamiliar, ‘un-medical’ and ‘managerial’, leading to reticence
about their use, not only because information would be shared with managers, but
also because they do not reflect the ‘realities’ of medical work. By adapting hospital
systems, these doctors were able to simultaneously demonstrate their willingness to
engage in more robust forms of learning, while evading the threat of managerial
, scrutiny over medical performance. Although the centralized reporting and learning
procedures remained intact and under managerial jurisdiction, these doctors
effectively opted out of their use in favour of their own adapted alternative.
- ‘circumventing’: doctors largely opted out of the systems being developed by the
Risk Management department on the grounds that they possessed a more
developed and superior system of learning, co-ordinated at the national professional
level and operationalized locally by a designated clinician. This further demonstrates
how pre-existing practices shape how doctors respond to management change but,
more significantly, how wider institutionalized practices can supersede those of
organizational managers.
Looking across our cases, we suggest that hybridization is not simply a matter of professional
elites being co-opted into managerial hierarchies as medical directors, nor the application of
bureaucratic standards over and within medical work. Rather, we suggest, somewhat
ironically, that managerial expertise can be detached from managers and drawn downwards
into professional practice. This enables professionals to avoid unwanted management
interference in work, and to extend their influence over management.
In short, management techniques are co-opted into professional work as a form of
resistance, with professionals becoming competent in management practice, rather than
professionals being co-opted into management roles. It could also be argued that such a
strategy, whilst maintaining professional autonomy, illustrates the ‘managerialization’ of
professional work. As professionals internalize management techniques in an endeavour to
stave off management encroachment, they become increasingly managerial in terms of their
practice and identity — the implication being that it negates the need for top-down
management controls over professionals, as it foster conformity from within professional
work. Managerialization may give the impression of self-control and autonomy but it may
also signify an important reconstruction of professionalism that potentially leads to
enhanced compliance to managerial intent.
, Noordegraaf, M. (2020). Protective or connective professionalism? How connected
professionals can (still) act as autonomous and authoritative experts.
Traditionally, professionals such as medical doctors, lawyers, and academics are protected.
They work within well-defined jurisdictions, belong to specialized segments, have been
granted autonomy, and have discretionary spaces. In this way, they can be socialized,
trained, and supervised, caserelated considerations and decisions can be substantive
(instead of commercial), and decisions can be taken independently. Ideally, these decisions
are authoritative and accepted, both by clients as well as society (stakeholders) who trust
professional services.
Protective shields in and around professionalism
When a group of workers within an occupational field manages to define and develop its
own field, backed by the state and linked to universities, they can form a profession. Within
an occupational field, there will be more formalized professions, which are identifiable
associations with members, operating within a certain jurisdiction.
The profession, in turn, consists of specialized segments, with distinctive professional
standards, both technical and ethical. These segments, in turn, consist of professionals who
do the real work. They are granted autonomy to act, both as members of a collective
association, as well as individually.
All of these features act as ‘protective shields’, which detach professionals and professional
work from the world, whilst at the same time serving the world. Taken together, these
shields determine
- what is protected (professions, work, autonomous action),
- how this is done (by way of legal, cultural, and symbolic technologies),
- who is protecting (the state, universities, and associations), and
- why this is done (to guard social utility).
Professionals can then determine which ways of working are effective, they can treat clients
and cases optimally, and they are accepted by clients, stakeholders, and society at large,
which means they have legitimacy. This constitutes the key dimensions of professionalism:
expertise, autonomy, and authority.
- Professionals treat clients well, and therefore society, by relying on state-of-the-art
knowledge, standards, and skills (expertise);
- by translating knowledge and standards to the needs and features of the case at
hand (autonomy); and
- by complying with and updating standards and codes (authority).
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