Competing Logics and Healthcare; Comment on “(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare”

Document Type : Commentary

Author

1 University of Suffolk, Ipswich, UK

2 University of Lincoln, Lincoln, UK

3 Royal Veterinary College, University of London, London, UK

4 University of St Mark and St John, Plymouth, UK

5 University of Toronto, Toronto, ON, Canada

Abstract

This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which – while not explicitly mentioned in the editorial – most effectively concretizes the tensions at the heart of this analysis of healthcare.

Keywords

Main Subjects

References

  1. Mannion R,  Exworthy M. (Re) Making the procrustean bed? standardization and customization as competing logics in healthcare. Int J Health Policy Manag. 2017;6(6):301-304. doi:10.15171/ijhpm.2017.35
  2. Blomgren M, Waks C. Coping with contradictions: hybrid professionals managing institutional complexity. Journal of Professions and Organization.2015;2(1):78-102.
  3. Freidson E. Professionalism: The Third Logic. Cambridge: Polity Press; 2001.
  4. Blank R, Burau V. Comparative Health Policy. 3rd ed. Basingstoke: Palgrave Macmillan; 2010.
  5. Lee K, Buse K, Fustukian S, eds. Health Policy in a Globalizing World. Cambridge: Cambridge University Press; 2002.
  6. World Health Organization. WHO Traditional Medicine Strategy: 2014-2023. WHO; 2013.
  7. Noordegraaf M. Hybrid professionalism and beyond: (New) forms of public professionalism in changing organizational and societal contexts. Journal of Professions and Organization.2015;2(2):187-206. doi:10.1093/jpo/jov002
  8. Carvalho T. Changing connections between professionalism and managerialism: a case study of nursing in Portugal. Journal of Professions and Organization. 2014;1(2):176-190. doi:10.1093/jpo/jou004
  9. Saks M. Review of theories of professions, organizations and society:Neo-Weberianism, neo-institutionalism and eclecticism. Journal of Professions and Organization. 2016;3(2):170-187.
  10. Saks M. The Professions, State and the Market: Medicine in Britain, the United States and Russia. London: Routledge; 2015.
  11. Liljegren A, Saks M, eds. Professions and Metaphors: Understanding Professions in Society. London: Routledge; 2016.
  12. Illich I. Limits to Medicine: Medical Nemesis: The Expropriation of Health. Harmondsworth: Penguin; 1976.
  13. Saks M. Medicine and the counter culture. In: Cooter R,  Pickstone J, eds. Medicine in the Twentieth Century. Amsterdam: Harwood Academic Publishers; 2000.
  14. Le Fanu J.  The Rise and Fall of Modern Medicine. 2nd ed. London: Abacus; 2011.
  15. Oldenburg J, Griskewicz M, eds. Participatory Healthcare: A Person-centred Approach to Healthcare Transformation. Boca Raton FL: CRC Press; 2016.
  16. Saks M. Professionalization, politics and CAM. In: Kelner M, Wellman B, Pescosolido  B, Saks M, eds. Complementary and Alternative Medicine: Challenge and Change. London: Routledge; 2003.
  17. Saks M. Health policy and complementary and alternative medicine. In: Kuhlmann E, Blank R, Bourgeault I, Wendt C, eds. The Palgrave International Handbook of Healthcare Policy and Governance. Basingstoke: Palgrave Macmillan; 2015.
  18. Porter, R. Blood and Guts: A Short History of Medicine. London: Allen Lane; 2002.
  19. 19.   Saks M. The alternatives to medicine. In: Gabe J, Kelleher D, Williams G, eds. Challenging Medicine. 2nd ed. Abingdon: Routledge; 2006. 
  20. Saks M. Empowerment, participation and the rise of orthodox biomedicine. In: Byrt R, Dooher J, eds. Empowerment, and Participation: Power, Influence and Control in Contemporary Health Care. Dinton: Quay Books; 2002.
  21. Saks M. Power and professionalisation in CAM: A sociological approach. In: Gale N, McHale J, eds. The Routledge Handbook of Complementary Medicine in Social Science and Law. London: Routledge; 2015.
  22. Saks M. Marginalized health professions. In: Cockerham C, Dingwall R, Quah S, eds. The Wiley-Blackwell Encyclopaedia of Health, Illness, Behaviour and Society. New York: Wiley-Blackwell; 2014.

Files

History

  • Receive Date: 17 June 2017
  • Revise Date: 08 August 2017
  • Accept Date: 09 August 2017
  • First Publish Date: 01 April 2018

Share

How to cite

Statistics