Professional Pride and Prejudice : Negotiating leadership in an era of interprofession-based organizing

Sammanfattning: Leadership has always played a peculiar role in the context of profession-based operations. Within bureaucratic yet decentralized organizational configurations – where conventional notions of labor management fall short in explaining executive functions – distributions of authority and influence have historically been inherent in strong hierarchies and meritocracies. Contemporary societal trends have, however, started to challenge traditional ways of organizing professional work. In the light of an emerging discursive antagonism, knowledge bases now to a fuller extent overlap each other, while diversified forms of professionalism add further to the complexity of interprofessional work arrangements. Where multifaceted social problems today command organizations to move beyond professional boundaries and assemble different occupations in interprofessional management teams, conflicting expectations of authorities and influence render the leadership concept more ambiguous than ever. Still, perspectives allowing for an understanding of how organizational direction is established among the many competing conceptions of professional practice prove to be limited. On a practical level, it has further been noted how ambiguities concerning influence and authorities foster a continuous negotiation that not only comes to impede interprofessional excellence, but also affects the quality of services offered to a client or a patient. In order to reap the potential of interdisciplinary collaboration in service provision, the understanding of this negotiation needs to be advanced. This can be achieved by shedding light on how organizational direction is established.Acknowledging how contemporary organizational arrangements call for new perspectives on leadership, the present work sets out to explore how dominant notions of professional practice are (re)produced in leadership processes. Informed by a social constructionist ontology, the theoretical frame of reference enriches a relational perspective on leadership with a negotiated order perspective on interaction. This approach moves beyond context-free conceptions of heroic leaders who are expected to bring their competencies to any suitable place, and rather recognizes how organizational direction is produced in more complex relationships between culturally situated actors.Through a case study at a Swedish university hospital, abductive assessment of mundane (non)interaction situations shed light on the pattern of basic assumptions that organizational arrangements of professional workers (re)construct in negotiation to cope with conflicting understandings of influence. While dominant conceptions of professional practice interfere with power bases in establishing recurrent patterns of interrelating, social practices within these patterns further stabilize a social order where (sub)professions associated with superior knowledge bases are – through collective, ‘humorous’ mechanisms – assigned an interpretative prerogative in organizational development. Rather than opening up for interprofessional collaboration in leadership work, mundane instances of interrelating thus (tacitly) reinforce a hierarchical structure, allowing established professions to retain control over the managerial apparatus. This further implies that organizational direction is more about informally reinforcing an organizational hierarchy than about pursuing change and moving beyond professional boundaries in decision-making structures – that is, contrary to how contemporary organizational arrangements presume dispersed forms of leadership. These insights reveal a clash between formalities and realities, which helps explain why change initiatives encounter obstacles, why production processes often prove inefficient, and why many multi-professional teams find it hard to excel. The dynamics and organizational consequences of leadership processes are productively summarized in a hierarchical leadership culture, where a general phenomenon of professional pride and prejudice sets the tone for recurrent patterns of interrelating.

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