Clinical management as boundary management

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Abstract
Focuses on the critical role played by professionals in the management of health‐care institutions in the UK and Canada. Using empirical data, examines the structural models of clinical management, the roles of clinical managers and their relationships with colleague professionals. Compares the approaches taken in the UK and Canada, and explores issues of context, history and relative power. Questions the extent to which professionals are losing autonomy to other professions and management. In particular examines whether the sharing of power inter‐professionally may lead to greater, overall collective professional autonomy. Develops themes of the contextual influences on the process of change, and whether professionals are more effectively managed by internal or external processes of control.