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Suggests that the route to “excellence” is through the empowerment of workers, but argues that this might become problematic within the health care sector. Examines the development of empowerment as a concept. Points out four different types of worker ‐the rebel, the mainstay, the high performer and the miserable sod, and their possible reactions to empowerment. Proposes ways of adapting the negative characteristics of these workers in implementing empowerment. Concludes that future action should be based on the introduction of empowerment rather than its discussion.

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