Embodying the Contemporary ‘Clinician-Manager’: Entrepreneurializing Middle Management?

Abstract

This chapter operates at the interstices of three domains: the theorization of identity; the entry of clinical professionals into ‘middle’ management, and the ‘post-bureaucratization’ of contemporary organizational relationships.¹ With regard to the first, the thematic opening chapter by Jay Lemke, as well as the other chapters in the present volume, provide a profound insight into the relevance and underpinning of identity as analytic construct. Lemke suggests that identity serves ‘to by-pass some of the persistent political conflict between more individualistic psychological paradigms and more socio-cultural ones’ (Lemke this volume). This produces the possibility, he argues, of connecting the semiotic manifestation of self (as meaning-making phenomenon) to its phenomenological (i.e., its experiential-affective) dimension. The most important point about Lemke’s exposition is that he sees identity as ultimately being traversed by a multitude of timescales. These traversals occur because, as citizens of the modern world, we link into people and things in complex and multiple ways: we use technologies made elsewhere — everything from language and transport to clothes and computers — enabling us to be in and move across different times, spaces and selves. This view of identity informs our analysis below of two clinicians’ interview narratives in which they describe themselves as hospital middle-managers.

‘Mobile amidst mobility’ illustrates with unparalleled clarity and generality the condition that modernized subjectivities will and must realize. Their sense of the great flexibilization manifests as the ability to navigate across the totality of all reachable places and objects without oneself getting ensnared in others’ nets. To realize oneself in this fluidity as subject — that is the absolute entrepreneurial freedom …

(Sloterdijk, 2004)