Professional bureaucracy

In professional bureaucracies, fhe patient is the central focus. All members of the organization, or team, have a primary goal in mind — for health care professionals this is improvement in the health and well-being of the patient. As such, health care professionals and not the managers develop the standards by which the patient is cared for. However, one of the drawbacks to this model is the potential for conflict among the professionals themselves, because many of fhe professionals will exercise expert or charismatic power and (most likely) the physician has primary legitimate power. 

Within firms, the hybrid or matrix concept has become increasingly fashionable in pharmaceutical companies. Project teams are created that comprise membership from departments with specific technical, organizational, and management expertise. Such teams form and dissolve as the need arises. In principle, advantages of the matrix structure include cross-disciplinary enrichment of the team s activities and crossfertilization of expertise. Disadvantages of the matrix system include a relative lack of professional development for specific technical expertise for each team member, the potential for cross-departmental rivalry, and competition for each team member s time based on the needs of the interdisciplinary project versus those of his/her technical "home" department (Verona and Ravasi 2003). These multi-functional teams have the potential to increase bureaucracy and delay innovation. At least on a small scale, it may be better to solve a problem with two people rather than with ten. 

Professionals often work within an organic-type setting. Consider, for example, the medical team on rounds at a hospital. Typically led by a physician, multiple professions are represenfed on fhe feam — medicine, nursing, pharmacy, social work, respiratory fherapy, and ofhers. In some ways, fhis represenfs a bureaucracy thaf is, fhe physician is in charge, with staff aufhorify over fhe ofher professionals. However, fhe feam differs from bureaucracy in thaf as fhe team sees patients on rounds throughout the... 

Unfortunately for partisans of orthodox economic theory, we are better informed about the beliefs of managers than of workers. There is a simple reason for this professional safety managers, the people who actually make these decisions within the corporate bureaucracy, undergo formal training in the tools of their trade. They learn how to adjust... 

Schriesheim [Fulk], J., Von Ghnow, M.A., and Kerr, S. 1977. Professionals in bureaucracies a structural alternative. In P.C. Nystrom and W.H. Starbuck (eds.). Prescriptive Models of Organizations. North-HoUand, Amsterdam, pp. 55-69. 

Autonomy To avoid the biases that contribute to the safety breakdown discussed in Chapter 6, there should be a mechanism of empowerment for systems engineers and safety professionals to be able to bypass the bureaucracy and hierarchy, especially early in the life cycle, in order to properly escalate safety concerns. This is particularly crucial in environments in which an increasing level of risk is accepted as the life cycle matures, based on the fact that failures did not occur while these risks existed. 

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