health care organizations and their power structures from the management

health care organizations and their power structures from the management

 This paper has an aim to examine health care organizations and their power structures from the management. We will also investigate the liable power structures that are derived from the bureaucratic theory basis. It is also essential to check the power that each organization represents based on empirical data. The paper will focus on analyzing Mintzberg’s power configurations of the instrument, political arena, closed system, and meritocracy, with Finland hospitals being the case study.

At the end of 2005, is when a survey was conducted about ten finish hospitals for primary care and the specialized one. The managers were the primary respondents, and some of the staff members from surgical and internal disease, primary care units, as well as outpatients. The data was analyzed statically, and the number of responses was about 38 per cent. Thus the results showed that some kind of organization structures supports a specific type of power generation. The first line managers took the health care organizations as those tools that are meritocracies with political arena features. The rules limited the managers’ positions while the members of the staff took their jobs to be having a lot of space (Anderson 2019). If the organizations seek the managers who are active at the unit level, then the structure of the organization should be changed, and the work re-distributed to provide more space for management that is meaningful.

This research has an aim to add to the literature and provide suggestions that are helpful that will make those in positions to gain interest. In health care organizations, power is not a very popular concept. The reason being the work of the professionals is to take care of the patients. All in all, healthcare organizations have no difference with other organizations. The organizations are complicated because of the individuals and coalitions that have different interests, values, beliefs, and preferences. There is, however, limited resources paving the way for a lot of competition that leads to conflicts.

Health care organizations in Finland are based on public provision. Thus the structures represent traditional organization models the likes of bureaucracy and professional organizations. The hospitals are, therefore, bureaucratic but decentralized. The nurses and doctors are regarded as the support staff. The tasks are delegated to the units by the managerial, introducing the administrative features to health care. Having discussed this, let’s talk about some concepts, as seen in the health care organizations.

Firstly, let’s discuss the power and its sources. The power concept addresses a wide range among the sociologists. On the other hand, influence is seen as being manifested in action through decision making that is concrete. Power is in three dimensional that is freedom, domination, or hegemony. Gaining control through shared information is what is referred to as hegemony. This is a kind of leadership that facilitates led autonomy. For this dimension to be successful, it has to dominate through consent (De Jong & Benton 2019). It contains a collective will. The power can also be interpersonal, structural, or individual. Structural, establishes a frame for personal strength. Power seeks balance, and it’s always relative. When power is used in the right way, then it is considered to be legitimate. When power is used for its reasons, then it is deemed to be illegitimate.

Worth noting is that there are various sources of power. These four sources are subdivided into four major categories. These are the discretion power, decision making, control of knowledge, and control of resources power. The core of every kind of management is making decisions. The manager must acquire enough information as possible to aid in choosing different options with their consequences. Resolutions can only be rational since not all outcomes can be predicted. In organizations, authority means the legitimate power that a person possesses to give orders and make decisions. More so, when a person is making the decision, then there is a need for discretion and choices between options. There are more significant opportunities at the unit level for preference. However, the power in an organization depends on the individuals or positions of the units.

Mintzberg’s configurations of power focus s on the organizational structure. The sources of power cannot be useful without taking action. Therefore, the ability to use sources of energy is very crucial as long as the power is being used effectively. The Mintzberg has divided the organization into five major parts. These parts include strategic apex, operating core, middle line, and technostructure and support staff.  All the alliances are both parts of power (Gunnarsdottir & Dellve 2018).

In health organizations, there is first-line management.  The lower-level managers are referred to as employees who have a hierarchical level that serves under them. In the sector of health care, it relates to nurses and physician managers at the unit level. The first-line managers are the members of the unit supervised and the managerial structure. The administrative roles are the same in first-line management. The only different thing is stressing. More so, the skills that are needed at a higher level may not be critical at the lower level. In the finish health care system, the management structure has two managerial lines. The professional groups are the nurses and the doctors. The administrative duties are different depending on the size of the unit. The only thing that is not clear is the position of the first line physician managers. They have a primary focus on clinical work.

The empirical study was done through a survey in the ten finish hospitals. These were the representative of the whole country. After the review, the results are that the mean values do vary from different organizations. The contemplation was finally made by comparing the number of valuables to the theoretical; framework (Patri &Suresh 2018). The first question to ask was whether the power for decision making was either decentralized or centralized. The target number two was to check on who makes the most critical decision for the unit.

On the side of the operation management, the nursing manager was the one making important decisions. The doctor’s managers were also found to possess a substantial role in decision making. The nurses and female managers were found to be more discreet than physicians and men. Worth noting is that the physicians were found to have a lot of discretion in clinical work but not in the managerial positions. This means that when the work has clear frames, then it is easier to show a preference.

The control of resources was also emphasized. The first-line managers, in this case, were found to be more positive than their subordinates. According to the respondents, bargaining and gambling were uncommon. Controlling of networks and knowledge was also examined by valuables and separate questions. Networking was found to have weaker importance in specialized care. The first line managers had a thought that they effectively distributed the information while the subordinates had a contrary opinion.

The last question was aimed at checking how the unit circulated the information. The aim was to ensure the managers had control of the knowledge of the organization. The groups and valuables gave value. No direct connections were noted between background variables. The research shows that the organization’s structures support the emergence of a certain kind of power. Natural power becomes an instrument when an organization is bureaucratic, depending on if there was an external influence or not. More so, an organization that is not result based cannot be linked directly to any power of the configuration.  The goal is meeting the focus regardless of the organizational structure. However, the organization can be connected to the meritocracy and political arena.

The decision power and discretion are limited for those first-line managers that are working in bureaucratic organization kind of structure. These mangers only follow the rules and the regulations that are set from the top. This is to say that their power is due to the position that is set by the hierarchy. On the side of the professional organizations, the expertise is more emphasized. Therefore, the power is bestowed on experts that are recognized in a particular specialty. Thus, the managerial role is to help experts in doing their duties. All the units are, however, held accountable for the results.

When comparing the results of the theoretical framework and the empirical study, the subordinate organizers of health seem to resemble a meritocracy organization and, more so, possess those features of the political arena (Sergi et al. 2016). The first line managers explained that the set rules limit their positions while the perspectives of the staff members see them from being influential and possessing a lot of space. According to staff members, the political arena and meritocracy resulted from surgical units. Regarding the results, at the level of individuals,  physicians at the occupational groups came up with their opinions. Therefore, for the first-line managers, the experience that was extensive in the healthcare and their duties as managers, were seen to be connected to meritocracy.

In summary, as we have mentioned earlier, the first-line managers and their subordinates, seemed to have a very different view on the issue of power that the healthcare organizations possess when observed through the first line kind of management. However, healthcare organizations do vary in many different ways. Some are private, and others are public. Every organization has different challenges. More so, they differ with each other due to the types of leadership and the organizational structures.

In most cases, the leadership’s styles are adjusted if they can’t adapt; there is the need to come with better measures that can fit well. For the organization to function better, especially in our case study Finland, then the qualifications for the managers need to be uniform and first-line managers to be trained well for the task. More so, there should be a revaluation of responsibilities and structures as well as explicit job discretion for sufficient discretion.

References

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