The challenges of managing interprofessional boundaries within multidisciplinary teams are well known. However, the role of intraprofessional relations in influencing the dynamics of interprofessional collaboration remain underexplored. Our qualitative study offers a fine-grained analysis of the interplay between inter- and intraprofessional boundary work among three professional groups in a multidisciplinary team over a period of two years. Our contribution to the literature is threefold. First, we identify various forms of “competitive” and “collaborative” boundary work that may occur simultaneously at both inter- and intraprofessional levels. Second, we reveal the dynamic interplay between inter- and intraprofessional boundary negotiations over time. Third, we theorize relationships between the social position of professional groups, and the uses and consequences of competitive and collaborative boundary work tactics at intra- and interprofessional levels. Specifically, we show how intraprofessional conflict within high-status groups may affect interprofessional dynamics, we reveal how intraprofessional and interprofessional boundaries may be mobilized positively to support collaborative relations, and we show how mobilization within lower-status groups around interprofessional boundary grievances can paradoxically lead to further marginalization.
AbbottA. (1988). The system of professions. Chicago: University of Chicago Press.
2.
AbbottA. (1995). Things of boundaries. Social Research, 62, 857–882.
3.
AhujaS.NikolovaN.CleggS. (2017). Paradoxical identity: The changing nature of architectural work and its relation to architects’ identity. Journal of Professions and Organization, 4, 2–19.
4.
AllenD. (1997). The nursing–medical boundary: A negotiated order?Sociology of Health & Illness, 19, 498–520.
5.
AllenD. (2000). Doing occupational demarcation: The “boundary-work” of nurse managers in a district general hospital. Journal of Contemporary Ethnography, 29, 326–356.
AntebyM.ChanC. K.DiBenignoJ. (2016). Three lenses on occupations and professions in organizations: Becoming, doing, and relating. Academy of Management Annals, 10, 183–244.
8.
Apesoa-VaranoE. C. (2013). Interprofessional conflict and repair: A study of boundary work in the hospital. Sociological Perspectives, 56, 327–349.
9.
Apesoa-VaranoE. C.VaranoC. S. (2014). Conflicted health care: Professionalism and caring in an urban hospital. Nashville, TN: Vanderbilt University Press.
10.
AshforthB. E.KreinerG. E.FugateM. (2000). All in a day’s work: Boundaries and micro role transitions. Academy of Management Review, 25, 472–491.
11.
BattilanaJ. (2011). The enabling role of social position in diverging from the institutional status quo: Evidence from the UK National Health Service. Organization Science, 22, 817–834.
12.
BechkyB. A. (2006). Gaffers, gofers, and grips: Role-based coordination in temporary organizations. Organization Science, 17, 3–21.
13.
BourdieuP. (1977). Outline of a theory of practice (Vol. 16). Cambridge: Cambridge University Press.
14.
BucherS.ChreimS.LangleyA.ReayT. (2016). Contestation about collaboration: Discursive boundary work among professions. Organization Studies, 37, 497–522.
15.
CharmazK. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: SAGE Publications.
16.
ChreimS.LangleyA.Comeau-ValléeM.HuqJ.-L.ReayT. (2013). Leadership as boundary work in healthcare teams. Leadership, 9, 201–228.
17.
CurrieG.FinnR.MartinG. (2008). Accounting for the ‘dark side’ of new organizational forms: The case of healthcare professionals. Human Relations, 61, 539–564.
18.
DingwallR. (1977). “ Atrocity stories” and professional relationships. Work and Occupations, 4, 371–396.
FinnR. (2008). The language of teamwork: Reproducing professional divisions in the operating room. Human Relations, 61, 103–130.
23.
FinnR.CurrieG.MartinG. (2010). Team work in context: Institutional mediation in the public-service professional bureaucracy. Organization Studies, 31, 1069–1097.
24.
FournierV. (2000). Boundary work and the (un)making of the professions. In MalinN. (Ed.), Professionalism, boundaries and the workplace (pp. 67–86). London: Routledge.
25.
FreidsonE. (2001). Professionalism: The third logic. Chicago: University of Chicago Press.
26.
GierynT. F. (1983). Boundary-work and the demarcation of science from non-science: Strains and interests in professional ideologies of scientists. American Sociological Review, 48, 781–795.
27.
GriffithsL. (1997). Accomplishing team: Teamwork and categorisation in two community mental health teams. Sociological Review, 45, 59–78.
28.
HallP. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, May2005Supplement 1, 188–196.
29.
HelfenM. (2015). Institutionalizing precariousness? The politics of boundary work in legalizing agency work in Germany, 1949–2004. Organization Studies, 36, 1387–1422.
30.
HernesT. (2004). Studying composite boundaries: A framework of analysis. Human Relations, 57, 9–29.
31.
HugmanR. (1991). Power in caring professions. Basingstoke, UK: Macmillan.
32.
IrvineR.KerridgeI.McPheeJ.FreemanS. (2002). Interprofessionalism and ethics: Consensus or clash of cultures?Journal of Interprofessional Care, 16, 199–210.
33.
KelloggK. C. (2009). Operating room: Relational spaces and microinstitutional change in Surgery1. American Journal of Sociology, 115, 657–711.
34.
LamontM.MolnárV. (2002). The study of boundaries in the social sciences. Annual Review of Sociology, 28, 167–195.
35.
LeathardA. (2004). Interprofessional collaboration: From policy to practice in health and social care. London: Routledge.
36.
LiberatiE. G.GorliM.ScarattiG. (2016). Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care. Social Science & Medicine, 150, 31–39.
37.
LincolnY. S.GubaE. G. (1985). Naturalistic inquiry. Newbury Park, CA: SAGE Publications.
38.
LockettA.CurrieG.FinnR.MartinG.WaringJ. (2014). The influence of social position on sensemaking about organizational change. Academy of Management Journal, 57, 1102–1129.
39.
MacdonaldK. M. (1995). The sociology of the professions. London: SAGE Publications.
40.
MartinG.CurrieG.FinnR. (2009). Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the `modernization’ of the medical workforce. Social Science and Medicine, 68, 1191–1198.
41.
MeierN. (2015). Collaboration in healthcare through boundary work and boundary objects. Qualitative Sociology Review, 11(3), 60–82.
42.
MillerK. L.KontosP. C. (2013). The intraprofessional and interprofessional relations of neurorehabilitation nurses: A negotiated order perspective. Journal of Advanced Nursing, 69, 1797–1807.
43.
MillerK. L.ReevesS.ZwarensteinM.BealesJ. D.KenaszchukC.ConnL. G. (2008). Nursing emotion work and interprofessional collaboration in general internal medicine wards: A qualitative study. Journal of Advanced Nursing, 64, 332–343.
44.
MintzbergH. (1979). The structuring of organizations. A synthesis of the research. Engelwood Cliffs, NJ: Prentice-Hall.
45.
NancarrowS. A.BorthwickA. M. (2005). Dynamic professional boundaries in the healthcare workforce. Sociology of Health & Illness, 27, 897–919.
46.
NugusP.GreenfieldD.TravagliaJ.WestbrookJ.BraithwaiteJ. (2010). How and where clinicians exercise power: Interprofessional relations in health care. Social Science & Medicine, 71, 898–909.
47.
PateJ.FischbacherM.MackinnonJ. (2010). Health improvement: Countervailing pillars of partnership and profession. Journal of Health Organization and Management, 24, 200–217.
48.
PouthierV. (2017). Griping and joking as identification rituals and tools for engagement in cross-boundary team meetings. Organization Studies, 38, 753–774.
49.
PowellA. E.DaviesH. T. (2012). The struggle to improve patient care in the face of professional boundaries. Social Science & Medicine, 75, 807–814.
50.
QuickK. S.FeldmanM. S. (2014). Boundaries as junctures: Collaborative boundary work for building efficient resilience. Journal of Public Administration Research and Theory, 24, 673–695.
51.
RodriquezJ. (2015). Who is on the medical team?: Shifting the boundaries of belonging on the ICU. Social Science & Medicine, 144, 112–118.
52.
SandersT.HarrisonS. (2008). Professional legitimacy claims in the multidisciplinary workplace: The case of heart failure care. Sociology of Health and Illness, 30, 289–308.
53.
SandsR. G. (1990). The social worker joins the team: A look at the socialization process. Social Work in Health Care, 14(2), 1–14.
54.
StraussA. L. (1978). Negotiations: Varieties, contexts, processes, and social order. San Francisco: Jossey-Bass.
55.
StringfellowL.ThompsonA. (2014). Crab antics? Contesting and perpetuating status hierarchies in professional service firms. Journal of Professions and Organization, 1, 118–136.
SvenssonR. (1996). The interplay between doctors and nurses: A negotiated order perspective. Sociology of Health & Illness, 18, 379–398.
58.
Vad BaunsgaardV.CleggS. (2013). ‘Walls or boxes’: The effects of professional identity, power and rationality on strategies for cross-functional integration. Organization Studies, 34, 1299–1325.
59.
ZietsmaC.LawrenceT. B. (2010). Institutional work in the transformation of an organizational field: The interplay of boundary work and practice work. Administrative Science Quarterly, 55, 189–221.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
