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As discussed in Chapter III, even though structures enable and constrain activity, it is through our choices that we either reinforce or change structures. Individuals may, therefore, choose actions to overcome constraining structures.

For example, through economic rationality, physicians concluded that adopting the Seniors Program was financially unfeasible. The fellowship, in turn, developed electronic documentation to automate the doctors’ work in an effort to reduce costs–that is, they developed new bureaucratic rationality (documentation & processes) to change clinics’ economic rationality.

Additionally, they informed physicians of fee codes available to reward some of the work they would do if they adopted the Seniors Program. This is an act of defining rationality to, again, change the clinics’ economic rationality.

The BC Health Authority further provided personnel to assist clinics, thus using bureaucratic rationality (procedures & roles) to support the program’s spread.

The figure below diagrams the above description using a critical realist framework.

 

“A critical realist perspective of overcoming constraining rationalities” by Brad C. AndersonDeveloping organizational and managerial wisdomKwantlen Polytechnic University is licensed under CC BY 4.0

 

Key Takeaways

  • Individuals may use different forms of rationality to overcome constraining structures.
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