東華大學圖書館 |

From Bureaucracy to Professionalism? Investigate a New Model to Organize Physician's Work in Urban China : = Multi-site Practice.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	From Bureaucracy to Professionalism? Investigate a New Model to Organize Physician's Work in Urban China :/
其他題名:	Multi-site Practice.
作者:	Ye, Chenyu.
面頁冊數:	1 online resource (186 pages)
附註:	Source: Dissertations Abstracts International, Volume: 83-10, Section: B.
Contained By:	Dissertations Abstracts International83-10B.
標題:	Sociology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29186406click for full text (PQDT)
ISBN:	9798426804432

From Bureaucracy to Professionalism? Investigate a New Model to Organize Physician's Work in Urban China : = Multi-site Practice.
Ye, Chenyu.

From Bureaucracy to Professionalism? Investigate a New Model to Organize Physician's Work in Urban China :Multi-site Practice. - 1 online resource (186 pages)

Source: Dissertations Abstracts International, Volume: 83-10, Section: B.

Thesis (Ph.D.)--The Chinese University of Hong Kong (Hong Kong), 2021.

Includes bibliographical references

Chinese physicians have traditionally been tethered to the organizations in which they practice, in particular, public hospitals. During the new round of ambitious medical reform, the multi-site practice policy was implemented to incentivize physicians and loosen the link between physicians and hospitals. This in-depth qualitative research focuses on the implementation of the multi-site policy in China by exploring the responses of different stakeholders and the mechanisms behind their behaviors.First, I investigate how physicians react to the multi-site practice policy and propose a two-dimensional model of competency and willingness to analyze their choices. The findings suggest that senior physicians were integrated into the hospital bureaucracy and lacked the incentives to seriously pursue multi-site practice. In terms of junior physicians, the training system channeled them into different tracks, which implied mismatch competency and willingness for multi-site practice. As a result, only a small proportion of physicians had both the willingness and the competency to participate in multi-site practice.Next, I turn to examine public hospitals' strategies in reaction toward the multi-site practice policy. Public hospitals have been faced with conflicting institutional logics and so they have widely adopted the decoupling strategy. I detailed different types of restrictive internal regulations hospitals launched to discourage physicians from multisite practice. I found that public hospitals have enjoyed extended autonomy and substantial discretion in the implementation process of multi-site practice. This is primarily because the goals of multi-site practice were difficult to quantify and local governments have tacitly agreed to retain physicians to ensure medical service capacity.Finally, I assess the operation of medical groups as sites for conducting multi-site practice. I classify Chinese medical groups into six categories and discuss how they organized physicians' work and influenced multi-site practice. I argue that although medical groups offered physicians a more desirable salary and autonomous practice environment, the pre-existing institutional structures of personnel and payment system significantly undermined their potential to serve as alternative practice sites.Taken together, this thesis shows how a seemingly ideal policy initiative of multisite practice did not work as intended in the real-world setting. Empirical data from three perspectives illustrate how Chinese physicians were embedded in a wider bureaucratic framework and kept under control. Through the lens of the implementation of multi-site practice, this thesis deepens our understanding of the relationship between hospitals and physicians in China and advances ongoing debates about the profession-organization relationship in different societal and institutional contexts.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798426804432Subjects--Topical Terms:

516174
Sociology.
Subjects--Index Terms:

Multi-site policyIndex Terms--Genre/Form:

542853
Electronic books.

From Bureaucracy to Professionalism? Investigate a New Model to Organize Physician's Work in Urban China : = Multi-site Practice.
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