NPM, Cooperation and Conflict: What's New in Multi-Professional Teamwork in Health Care?

The discussion connecting professions and organizations particularly in the context of growing managerial frameworks, shows controversy concerning professionals’ performance of their roles. Does professionals’ identity and strategies are being shaped by entrepreneurial values? Or does professionals still to employ both individual and group strategies to maintain and reinforce their autonomy? This paper concerns multi-professional teamwork in health care in contexts of strong economic and efficiency controls resulting from the New Public Management (NPM) reforms.

Efforts between different health professionals and work groups often result in conflict and tension. Cooperation difficulties are thought to exist and many of this problems are assumed as associated with (but not only) the differences between the several professional self-governance mechanisms involved in the multi-professional teams. Although, as several sociological studies show, most of this conflicts are built from the drawing of boundaries between medical specialties (Serra, 2011) and different health professions.

As teamwork is a network of semi-independent professionals who tend to repre­sent their professional organisations and groups despite sharing a mutual inte­rest in the patients,  frontiers between different health professions act, on the one hand, as articulating mechanisms to be found in the division of health work and as barriers to the interaction of the various skills. The argument is that NPM reforms in health care may not have improved the situation. Given these conditions, there is a good reason to understand how cooperation between different health professions is constructed as they work together in the best interest of patients. However, it is also possible that the continued influence of professional self-governance and the increasing strength of management mechanisms will resulting in new arrangements in terms of professionalism.