Public Healthcare Governance in Hong Kong: A Study on the Emergence of Hybrid Physician Managers

The emergence of hybrid physician managers in hospital management in western countries under New Public Management has attracted researchers’ attention in the past two decades. However, it is under-explored outside the West. As a former colony of Britain, Hong Kong has a legacy of the NHS-style universal public hospital system based on western medicine and a liberal profession of medicine. Similar to the UK, the 1990s and 2000s saw rapid changes in Hong Kong that aimed to modernize the healthcare sector in terms of efficiency and transparency/accountability. The landscape of healthcare governance in Hong Kong is in the same way shaped by the interplay between the state and professional powers. Although researchers in this field are commonly inspired by the Re-Stratification thesis that sees medicine as being divided into two groups, rank-and-file doctors and medical elites who enrol into the administrative and regulatory posts, only a few empirical studies focus on the identity work of hybrid physician managers as the pivotal players in healthcare reforms. Indeed, it is not only the capacity but also the loyalty of medical elites to their peers that decides whether or not the collective control of medicine on healthcare management can be preserved. Examining the Hong Kong case, this research aims to have the physician managers’ first person narratives on their management role in healthcare, with special attention to their social identification with professional colleagues and organizations. In view of a more sophisticated understanding of physician managers’ hybrid identities, a new analytical approach is developed based on previous studies. It is found that physician managers try to satisfice both professional and organizational values, while maintaining respective jurisdictions in policy making and clinical governance, as well as their primary self-identification as rationalizers or protectors of medicine, according to their manager roles as directorial and departmental managers.