Identity types
2
of constructs of identity exist to form coherent identity types. Specifically, this study
investigates the ways in which physicians in three different organizational contexts view
themselves and the world in which they practice medicine. Physicians are particularly
interesting to study in terms of organizational identity because they are thought to have a clear
sense of professional identity. We first review the literatures on physicians in organizations,
physician identity and the current environment of medicine. Then we describe the details of our
method of data collection and analysis. Next we detail our findings followed by a discussion of
the implications of this study in light of organizational communication and physician identity.
Physicians and organizations
Physicians practice medicine in many different organizational contexts, ranging from
large integrated delivery systems (Shortell, Morrison, & Freidman, 1989), hospitals (Kimberly &
Evanisko, 1981), HMO staff or group models (Gross & Budrys, 1991), or the more traditional
solo, partnership, or small group practice (Anderson & Wakefield, 2001). Each of these
“practice settings” in which physicians work are organized work environments that can produce
tensions due to different organizational structures or different ways of organizing (Freidson,
1970; Scott, 1966). Since the organization is increasingly more involved in physicians’ lives and
the delivery of health care, a brief look at existing types of organizational contexts, or practice
settings, in which physicians practice medicine is useful here.
One trend is the growth of the number of group practices. It is estimated that 65 percent
of all self-employed physicians practice in small groups (Bodenheimer, 1999). The primary
reason for this growth has been physician response to competitive market dynamics and the
increased risk of “going it alone” (Hoff, 2001a). A second trend has been the dramatic increase
in the number of physician employees. According to Friedman (1995), there has been a major
Convention