The multi-professional team as a post NPM control regime

Can it integrate competing control regimes in healthcare?

Abstract

This paper focuses on multi-professional teams (MPT) as a potential post New Public Management (NPM) control regime in order to develop individualistic and holistic care in healthcare in the context of two competing logics: managerialism and professionalism. In a qualitative case study, three outpatient Child and Adolescent Psychiatric (CAP) care units are investigated using interviews, observations and shadowing. The study shows that the MPT has an integrative effect on the two logics when informal alliances are formed between psychologists/psychiatrists and unit managers. We conclude that the MPT may achieve patient care in a resource-effective and professional way but not individualistic and holistic care. An explanation may be that individualistic and holistic care is neither measurable/quantifiable as required by the resource-effectiveness goal nor in focus as a consequence of the logic of professionalism. A theoretical implication is that the negative effect of NPM on the professionals’ autonomy is mitigated by the MPT. Earlier studies may have underestimated the importance of “hard facts” introduced by a strong control regime, in this case, the NPM context. The control regime may take over and create collaboration; nonetheless, the outcome is not entirely the desired one.