Luminary Learning Gastrointestinal Disorder- Issue 1

44  ‘Clinicians versus clinicians versus managers’ or a new patient centred culture that eradicates ‘them and us’? Jill Aylott, Prasad Godbole, Derek Burke Doctors in the NHS are often singled out and blamed for individual behaviour that is some- times labelled ‘difficult’ ‘obstructive’ ‘resistant to change’ and ‘downright awkward’. In an English NHS system that is highly managed by a majority of non-clinicians at an NHS Trust Board level and controlled by politicians in terms of priorities and budget, an individual doctor’s behaviour might better be understood within social identity theory (SIT) [1] as a normative response to an increasingly antagonistic context within the English NHS. SIT is a psychological theory that argues that a person’s concept of ‘self ’ comes from the groups to which the person belongs and that they will seek to identify with others who are also associated with this same group to help form a positive social identity, which will result in feelings of high esteem and positive wellbeing. Within hospitals, specialisms and sub-specialisms of medical and surgical practice creates highly skilled doctors and surgeons who work within increasingly highly specialised areas. Such a high level of specialism will require even closer attention to team working within health care to provide patients with a more holistic and patient centred service. However, in reality there might well be tensions between the objectives of team working and collective leadership and the motivation of individual specialists who seek to preserve their professional identity and the skills associated within their professional role. While clinicians seek to preserve their identity within their clinical role, they may not wish to participate in sharing medical/professional practice, which is suited both to their own skills and the skills of their colleagues, but will be defined separately within their own Royal Colleges’ ‘scope of practice’. This is a challenge for organisations who require more 4 J. Aylott (  ) Directorate for International MBA Programmes, International Academy of Medical Leadership, Sheffield, UK e-mail: Jill.Aylott@iamedicalleadership.com P. Godbole Department of Paediatric Surgery, Sheffield Children’s NHS Foundation Trust, Sheffield, UK e-mail: Prasad.Godbole@sch.nhs.uk D. Burke Department of Emergency Medicine, Sheffield Children’s NHS Foundation Trust, Sheffield, UK e-mail: derek.burke@sch.nhs.uk BeyondMedicine