The Relationship between Organisation Structure and Management Control in Hospitals: An Elaboration and Test of Mintzberg’s Professional Bureaucracy Model

The conflict between professional and bureaucratic models of behaviour has long been recognised. Evidence provided in the professional/bureaucratic literature indicates that this conflict will impact on the effectiveness of management control systems when dominant professionals, such as physicians, are incorporated into bureaucratic organisations. This article elaborates Mintzberg′s (1979) professional bureaucracy model and empirically examines a number of propositions concerning the way in which activities are controlled and coordinated in hospitals. An analysis of 192 subunit managers in four large Australian teaching hospitals indicated significant differences in the use of control and co‐ordinating mechanisms by health care professionals who manage core operating subunits and managers of subunits which provide support services. These differences do not all follow the predictions of Mintzberg′s model.