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Performance appraisal for doctors: A case of paperwork compliance

Performance appraisal for doctors: A case of paperwork compliance
Performance appraisal for doctors: A case of paperwork compliance
This paper discusses the findings of research exploring the conduct of portfolio-based performance appraisal within medicine. Portfolios are now used throughout medical school and junior doctor training, in later specialist training, as well as to support the implementation of annual NHS appraisal of doctors as part of their employment contract. They will also play a role in the new medical governance quality assurance process known as revalidation, when it is implemented in 2010. The paper discusses how the growth of portfolio-based performance appraisal within medicine is bound up with the growth of managerial systems of surveillance and control within western health care systems. Theoretically, it draws upon a Governmentality perspective to analyse doctor's accounts of the appraisal process. This views appraisal as an information panopticon that to better enable social control seeks to construct appraisees as calculable and administrable subjects. However, the paper highlights how the doctors interviewed used the tacit dimensions of their expertise to engage in creative game-playing toward appraisal, adopting a stance of paperwork compliance toward it. Paperwork compliance leaves a paper trail that makes it appear doctors have complied with the technical requirements of performance appraisal when in fact they have not. The paper concludes that current reforms to medical governance introduced to ensure the general public is protected from medical error and malpractice, provide sociologists with an invaluable opportunity to undertake a dedicated research program into the performance management of medical work.
annual appraisal, audit society, governmentality, medical autonomy, medical regulation, paperwork compliance, performance appraisal, revalidation
1360-7804
1-9
Chamberlain, J.
d8b66386-a907-45ea-9e64-3f3e77359dc8
Chamberlain, J.
d8b66386-a907-45ea-9e64-3f3e77359dc8

Chamberlain, J. (2010) Performance appraisal for doctors: A case of paperwork compliance. Sociological Research Online, 15 (1), 1-9. (doi:10.5153/sro.2099).

Record type: Article

Abstract

This paper discusses the findings of research exploring the conduct of portfolio-based performance appraisal within medicine. Portfolios are now used throughout medical school and junior doctor training, in later specialist training, as well as to support the implementation of annual NHS appraisal of doctors as part of their employment contract. They will also play a role in the new medical governance quality assurance process known as revalidation, when it is implemented in 2010. The paper discusses how the growth of portfolio-based performance appraisal within medicine is bound up with the growth of managerial systems of surveillance and control within western health care systems. Theoretically, it draws upon a Governmentality perspective to analyse doctor's accounts of the appraisal process. This views appraisal as an information panopticon that to better enable social control seeks to construct appraisees as calculable and administrable subjects. However, the paper highlights how the doctors interviewed used the tacit dimensions of their expertise to engage in creative game-playing toward appraisal, adopting a stance of paperwork compliance toward it. Paperwork compliance leaves a paper trail that makes it appear doctors have complied with the technical requirements of performance appraisal when in fact they have not. The paper concludes that current reforms to medical governance introduced to ensure the general public is protected from medical error and malpractice, provide sociologists with an invaluable opportunity to undertake a dedicated research program into the performance management of medical work.

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More information

Accepted/In Press date: 21 January 2010
e-pub ahead of print date: 28 February 2010
Keywords: annual appraisal, audit society, governmentality, medical autonomy, medical regulation, paperwork compliance, performance appraisal, revalidation
Organisations: Social Sciences

Identifiers

Local EPrints ID: 385889
URI: https://eprints.soton.ac.uk/id/eprint/385889
ISSN: 1360-7804
PURE UUID: ed01e9b3-9fdd-4d56-b894-f85e990211b4

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Date deposited: 25 Jan 2016 16:38
Last modified: 17 Jul 2017 19:53

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Author: J. Chamberlain

University divisions

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