Institutional Logics and Institutional Pluralism: The Contestation of Care and Science Logics in Medical Education, 1967–2005

  title={Institutional Logics and Institutional Pluralism: The Contestation of Care and Science Logics in Medical Education, 1967–2005},
  author={Mary B. Dunn and Candace Jones},
  journal={Administrative Science Quarterly},
  pages={114 - 149}
Although most studies underscore institutional change as replacement of one dominant logic for another and assume that professions are guided by a single logic, professions that operate in multiple institutional spheres often have plural logics. We focus on medical education, the supplier of medical professionals, which resides at the interstices between academia and healthcare. Using archival sources from 1910 to 2005, we identify two logics central to the profession that persisted over time… 

Figures and Tables from this paper

Who will lead the physicians unwilling to lead? Institutional logics and double-bind situations in health care leadership
Purpose – Health care organizations are increasingly demanded to balance the institutional logic of “medical professionalism” and “business-like health care,” that is, to both recognize physicians’
Coping with contradictions: hybrid professionals managing institutional complexity
This article deals with how organizations cope with institutional complexity. By applying theories of translation, we follow the lead of those arguing that attention has to be given to the
Universities as Hybrids: Applications of Institutional Logics Theory to Higher Education
Abstract The goal of this chapter is to review the potential of institutional logics theory for the study of higher education. After providing a concise introduction to institutional logics, the
The sensemaking narratives of scientists working in health professions education scholarship units: The Canadian experience
This research explores how health professions education scientists uphold and/or upend the institutional logics of the units they work within and indicates a need to reconceptualize the institutional value associated with these endeavors.
Institutional Pluralism, Organizations, and Actors: A Review
The institutional logics perspective holds the promise of delivering where neo-institutionalist theory has disappointed – the ability to address key societal problems such as inequality, social
Sustaining a plurality of imperatives: an institutional analysis of knowledge perspectives in Swedish social service policies
Social services are among the public policy areas criticized for lacking a reliable knowledge base to support professional as well as political ambitions and actions. This article contributes to the
Strategic and Enforced Logics Hybridization: An Agency View within French Hospitals and Universities
Abstract Adopting an agentic positioning, we question and compare competing logics hybridization within French hospitals and universities facing major reforms inspired by new public management. In
From Agents to Principles: The Changing Relationship between Hospitalist Identity and Logics of Health care
Institutional logics and collective identities are closely intertwined: logics shape the emergence and evolution of identities, which in turn play a crucial role in mediating the influence of the


Markets from Culture: Institutional Logics and Organizational Decisions in Higher Education Publishing
Institutional logics, the underlying governing principles of societal sectors, strongly influence organizational decision making. Any shift in institutional logics results in a similar shift in
The New Institutionalism in Organizational Analysis
Long a fruitful area of scrutiny for students of organizations, the study of institutions is undergoing a renaissance in contemporary social science. This volume offers, for the first time, both
Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care
Time to Heal is a landmark account of American medical education in the twentieth century, concluding with a call for the reformation of a system currently handicapped by managed care and by narrow, self-centered professional interests.
Institutional Logics and the Historical Contingency of Power in Organizations: Executive Succession in the Higher Education Publishing Industry, 1958– 19901
This article examines the historical contingency of executive power and succession in the higher education publishing industry. We combine interview data with historical analysis to identify how
Institutional change and healthcare organizations: from professional dominance to managed care
  • D. Light
  • Medicine, Political Science
    International Journal of Integrated Care
  • 2002
This book is a masterpiece of historical work and organisational analysis of the ‘buyers’ revolt’ that occurred in the 1980s when those who had long paid the bills became so fed up by the waste, excesses, and variability of services delivered under professional dominance that they started to take forceful action.
Social Ontology and the Dynamics of Organizational Forms: Creating Market Actors in the Healthcare Field, 1966–1994
Social scientists have evidenced a long-standing interest in the cultural construction of ontologies - symbolic systems of categorization and meaning- but have yet to develop a widely recognized
The social transformation of american medicine.
  • Msmw
  • Medicine
    The Western journal of medicine
  • 1983
The Social Transformation of American Medicine is one of the most comprehensive studies on the rise of the medical profession and the development of the health care industry published to date, Starr
Entrepreneurial firms such as professional service firms (PSFs) face constant challenges to acquire resources, one of the greatest of which is the challenge to win client engagements. Although
A Tale of Two Cities: Competing Logics and Practice Variation In the Professionalizing of Mutual Funds
This article examines practice diffusion in an environment where competing logics exist, specifically investigating how trustee and performance logics that were rooted in different locations (Boston