Dialogues and dialetics: Limits to clinician–manager interaction in healthcare organizations.

Robert MacIntosh, Nic Beech, Graeme Martin

    Research output: Contribution to journalArticlepeer-review

    24 Citations (Scopus)


    This paper examines clinician—manager interactions within healthcare organizations in the UK and contrasts the notions of dialetics and dialogues within such interactions. We draw particularly on Bakhtin’s work on dialogue to frame our focal research question, which considers the extent to which clinician—manager interactions are dialogic. Using data drawn from a thirty-two month study of five UK healthcare organizations we suggest that clinician-manager interactions are more dialectic than dialogic in their orientation. Further, we suggest that, despite the appearance of dialogical possibility between clinicians and non-clinicians, the tendency to dialectic positioning reinforces opposition between these groups and we conclude that local, rather than system-wide interventions, offer the best means of disrupting these dialectics and fostering productive dialogues. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
    Original languageEnglish
    Pages (from-to)332 - 339
    JournalSocial Science and Medicine
    Issue number3
    Publication statusPublished - Feb 2012


    • dialectics, clinician manager interaction, health care organizations, primary health care, health care services, managed care, Clinicians, Health Care Services, Managed Care, Primary Health Care, Dialectics, Organizations


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