Hybridsjuk vård - Hur allmänläkarens möjlighet att styras utifrån professionslogik påverkas till följd av NPM i primärvården.

Sammanfattning: This study examines whether and how New Public Management (NPM), bringing Bureaucratic and Market institutional logics to the sector of primary care, impacts the ability for medical doctors to organize their work per the logic of professionalism. Hence, this rapport is built upon a two sided key issue: how NPM is changing the organizational conditions for the health care providers in Sweden, providing institutional change and; how Bureaucratic logic and Market logic are conflicting with the logic of Professionalism. The situation is studied by how members of the key profession of this sector, medical doctors, are affected. The study is performed as a qualitative method by interviewing ten medical doctors with the same area of specialization, working at primary care health clinics in Stockholm. The aim is to understand their experience of the organization of their daily work. Apparently, the aspirations of NPM reforms with an empowered clientele of patients and formally structured organizations have been achieved in Swedish primary health care. Findings show there is apparent influence from both Bureaucratic logic and Market logic on the work of medical doctors. The area of influence from the logic of professionalism is minor. Findings propose that too individualistic work is a diminish factor for the ability of professionals to prevail an institutional change. Professionals must either embrace a hybrid profession or engage themselves as a stronger collegial force to imply change in accordance to their professionalism.