Managing different forms of distances in Dutch healthcare organizations.

Purpose – Dichotomous “gap” thinking about professionals and managers has important limits.
The purpose of this paper is to study the specific ontology of “the gap” in which different forms of distances are defined.

Design/methodology/approach – In order to deepen the knowledge of the actual day-to-day tasks of Dutch healthcare executives an ethnographic study of the daily work of Dutch healthcare executives and an ontological exploration of the concept “gap” was provided. The study empirically investigates the meaning given to the concept of “distance” in healthcare governance practices.

Findings – The study reveals that healthcare executives have to fulfil a dual role of maintaining distance and creating proximity. Coping with different forms of distances seems to be an integral part of their work. They make use of four potential mechanisms to cope with distance in their healthcare organization practices.

Originality/value – The relationship between managers and professionals is often defined as a dichotomous gap. The findings in this research suggest a more dynamic picture of the relationship between managers and professionals than is currently present in literature. This study moves “beyond” the gap and investigates processes of distancing in-depth.