Hybridisation or Polarisation: Doctors and Accounting in the UK, Germany and Italy

This paper describes a study of doctors and the education of doctors in Germany, Italy and the UK and the changing location of accounting practices and expertise. In these countries there have been coercive reform attempts to get doctors to accept increased financial responsibility and pay greater attention to costs and budgets. Kurunmaki (2004) suggested that Finnish doctors have willingly adopted accounting practices as part of their legitimated competencies and have become a hybrid profession. This paper address the question of whether that is a valid generalisation in Germany, Italy or the UK. The key focus of the paper is on the education and training of doctors, which should have altered if hybridisation has occurred. The finding is that there is no evidence from the countries studied that accounting has become incorporated into the formal education of doctors. While there were management and accounting training courses for doctors these were only available for those in or aiming for clinico-managerial positions. This does not support the argument that medicine has become a hybridised profession, but it does support the case for polarisation. These changes are absorbed or managed by an emergent sub-group, the medical manager.

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