Please check out the new Special Issue of Work and Occupations:
Consequences of Change in Healthcare for Organizations, Workers,
and Patients
Guest Editors: Ariel C. Avgar (Cornell University), Adrienne E. Eaton
(Rutgers University), Rebecca Kolins Givan (Rutgers University), and Adam Seth Litwin (Cornell University)
A pandemic of as yet unknown duration is changing the world. We do not know exactly how, but we can be certain this global crisis will upend governments and challenge the established social order. While the edifice of healthcare provision may well be transformed, institutions, relationships and path-dependent structures will determine precisely how this transpires and what system will emerge on the other side. While the research presented in this special issue was completed before the Covid-19 pandemic arrived, the articles all shed light on how healthcare organizations can and will respond to this unprecedented challenge. The current crisis has highlighted a host of shortcomings in existing employment models, training, incentives, use of technology, supply chains, funding and investment, and so much more. What is certain, though, is that healthcare systems and organizations must change. The articles in this special issue suggest the most appropriate direction of change. Centering the needs of employees generally and, more specifically, employee voice and professional expertise, quality care, and investment in healthcare provision itself rather than bureaucracy or administration related to payment systems will prove critical.
Menchik focuses on doctors’ (i.e., cardiologists’) adoption of a new robotic technology that mediates between the doctors’ hands and the patient. He develops a two-factor typology of individual approaches to adopting the new technology focused at one axis on the degree to which a doctor is influenced by their initial training and at the other, the influence from current colleagues. Also examining the link between work and technology, Wu compares the use of paper records to tablet computers for recording data on patient encounters by home health aides. Managers in the paper system mediated between the paper records created by direct care providers and the institutions’ official records; those in the tablet system are reduced to teaching and exhorting direct care workers to properly use their tablets. VanHeuvelen and Grace examine the move from a multi occupancy ward design to single-patient rooms. They find that occupational groups differed in their embrace or resistance to the change with some groups focused on the impact on patient care and others more on changes to working conditions. Wiedner et al. examine an explicit attempt to change occupational roles in the English National Health Service by shifting elements of budgetary responsibility from career managers to physicians. They find that tensions among occupational groups, rooted in their differing “dispositions,” can derail an attempt at change. Batt, Kallas, and
Appelbaum compare the labor relations approaches of employers in the healthcare systems in the upstate New York cities of Rochester and Buffalo. They argue that the different historical paths of industrial development in each city drove disparate labor relations approaches with one emphasizing a more positive, cooperative stance by management and the other more anti-union and hostile. In turn, they argue these approaches dictated the different paths healthcare employers in each city took in more recent restructuring.
Articles
Paying the Price for a Broken Healthcare System: Rethinking Employment, Labor, and Work in a Post-Pandemic World
Avgar, A., Eaton, A.E., Givan, R.K. and Litwin, A.S.
Occupational Heterogeneity in Healthcare Workers’ Misgivings about Organizational Change
VanHeuvelen, J.S. and Grace, M.K.
Moving From Adoption to Use: Physicians’ Mixed Commitments in Deciding to Use Robotic Technologies
Menchik, D.A.
GPs are from Mars, Administrators are from Venus: The Role of Misaligned Occupational Dispositions in Inhibiting Mandated Role Change
Wiedner, R., Nigam, A. & Bento da Silva, J.
Path Dependency Versus Social Unionism in Healthcare: Bringing Employers Back In
Batt, R., Kallas, J. & Appelbaum, E.
Organizations, Occupations and Work 