Making do by getting real: Psychological contract violations and proactive career agency among medical professionals.

Background: Health care professionals face greater uncertainty in their careers as traditional jobs wither and new, organizationally controlled jobs proliferate, reducing economic security and professional autonomy.

Purpose: We apply psychological contract and self-efficacy theory to examine the career agency of early-career physicians. We ask the following: (a) What are the unfulfilled expectations and emotions experienced by young physicians at the training and early career stages? (b) What are the forms of career agency exhibited by young physicians in response to unfulfillment?

Methodology: We conducted a study on 48 U.

Merger and post-merger integration at Oxford University Hospitals: mixed-methods evaluation and lessons learned.

Purpose: Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size.

Making sense of effective partnerships among senior leaders in the National Health Service.

Background: Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders.

Purpose: The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K.