Dialogues and dialectics: limits to clinician-manager interaction in healthcare organizations

MacIntosh, R., Beech, N. and Martin, G. (2012) Dialogues and dialectics: limits to clinician-manager interaction in healthcare organizations. Social Science and Medicine, 74, pp. 332-339. (doi:10.1016/j.socscimed.2011.03.014)

Full text not currently available from Enlighten.


This paper examines clinicianemanager interactions within healthcare organizations in the UK and contrasts the notions of dialetics and dialogues within such interactions. We draw particularly on Bakhtin’s work on dialogue to frame our focal research question, which considers the extent to which clinicianemanager interactions are dialogic. Using data drawn from a thirty-two month study of five UK healthcare organizations we suggest that clinician-manager interactions are more dialectic than dialogic in their orientation. Further, we suggest that, despite the appearance of dialogical possibility between clinicians and non-clinicians, the tendency to dialectic positioning reinforces opposition between these groups and we conclude that local, rather than system-wide interventions, offer the best means of disrupting these dialectics and fostering productive dialogue

Item Type:Articles
Glasgow Author(s) Enlighten ID:Martin, Professor Graeme and MacIntosh, Professor Robert
Authors: MacIntosh, R., Beech, N., and Martin, G.
Subjects:H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
College/School:College of Social Sciences > Adam Smith Business School > Management
Journal Name:Social Science and Medicine
Published Online:25 March 2011

University Staff: Request a correction | Enlighten Editors: Update this record