Developing a New Medical Identity Through Institutional Work: A Hospitalist in a Finnish University Hospital

Abstract

This paper examines how staff at a Finnish hospital develop a new medical identity amidst other already-established professions. This study was conducted during the merger of two surgical departments at a public Finnish university hospital, and concerned the identity development process of a hospitalist which was, at the time, an entirely new medical role at the hospital. Drawing on extensive videos of authentic team meetings and entries in various actors’ reflective diaries, we find that the actors collectively developed the new medical identity during the change process by using the following reflexive strategies: (1) identity inquiry; (2) identity reflection; and (3) identity legitimacy. These strategies foster temporary identity claims while the new medical identity is developed through experimentation and discourse, culminating in an identity that acquires stability within the ward environment. We found that an environment allowing transparent and open dialogue, in this case through periodic change facilitation meetings, was conducive to the development of a new identity.