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Human Relations
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Power Acquisition in a Health Care Setting: An Application of Strategic Contingencies Theory

Bruce J. Fried

Department of Health Administration, University of Toronto, McMurrich Building, Toronto, Ontario, Canada M5S 1A8.

Strategic contingencies theory suggests that uncertainty coping, nonsubstitutability, and centrality predict intra-organizational group power. This theory was tested in 20 ambulatory care clinic settings. Physician, nurse, and administrator power and roles were examined. Theoretical support was greatest among nurses, but less conclusive for physicians and administrative personnel, whose roles in the clinics were more clearly prescribed and determined, and influenced to a lesser degree by power-enhancing dynamics. Implications are discussed of the relevance and usefulness of strategic contingencies theory and other theories of organization in health services organizations.

Human Relations, Vol. 41, No. 12, 915-927 (1988)
DOI: 10.1177/001872678804101203


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