This study investigates how employment in large-scale organizations affects the work lives of practicing physicians. Well-established theory associates larger organizations with bureaucratic constraint, loss of workplace control, and dissatisfaction, but this author finds that large scale is also associated with greater schedule and career flexibility. Ironically, the bureaucratic processes that accompany large-scale organization also allow for a reduction of patient demands on individual physicians, freeing those physicians to pursue other career activities or to fulfill family responsibilities. Large-scale organizations thus appear to represent a trade-off between workplace control and temporal flexibility, and many physicians appear to embrace this trade-off. The data come from surveys and interviews conducted in 2002. Implications extend to other professional and managerial labor markets in which client demands constrain schedules and careers.
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