In many western countries, medical specialists are becoming more and more integrated in hospital management. A medical professional in the lead could be a bridge between two worlds, the medical and the management world, each with their own logic. He could influence the clinical activities of his colleagues, more than a non medical manager. However, this seems not to be a trouble-free task. The author of this thesis supports medical chairs in a university hospital in their leadership. From these experiences, the assumption arose that the characteristic patterns which emerged are related to the specific culture and manners of the medical world. This research addresses the question: how does the specific medical identity, the medical habitus, influence the task of leadership of the medical chair? The study has been performed in a university hospital. Observations, interviews and interactive discussion groups in the form of small learning groups with department heads have been used to gather the empirical material. First, the medical habitus is described. Also, the hidden curriculum becomes visible, the socialization process in which the habitus is formed. By influencing the power and collegial relations within the group, the medical habitus determines to a greater extent the limitations and possibilities of the leadership of the department head. The department head needs to be a good doctor and colleague and to serve as a model in order to influence the clinical activities and the performing of his group. Sometimes he disposes managerial behaviour, but the medical habitus remains his true second nature. If the chair inclines towards the management world too much, he loses his surplus value in the group. Based on the findings of this study, several points of attention have been formulated, regarding the importance of the hidden curriculum, of the position and support of medical professionals in the lead and of the balance between the two worlds in a hospital.

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D.L. Willems (Dick) , P.L. Meurs (Pauline)
Erasmus University Rotterdam
Erasmus School of Health Policy & Management (ESHPM)

Witman, Y. (2008, February). De Medicus Maatgevend: over leiderschap en habitus. Retrieved from