Organisational analysis

Organisational analysis

Introduction

A multidisciplinary clinic was established in an inner city general practice. Using the approach of co-operative inquiry, the clinicians involved explored their joint practice to better understand the nature of multidisciplinary practice. This paper focusses on issues of power and conflict which arose in the course of this work, and makes suggestions for future practice.

In this paper I want to explore some of the group and interpersonal issues which arise when general medical and complementary practitioners work together. Particularly I want to look at this in terms of power and power conflicts, and to attempt to understand some of the deep-seated causes of misunderstanding which may arise between practitioners who are good working colleagues and who hold each other in considerable respect.

However, before exploring these issues of power and conflict I shall first describe the setting and briefly discuss co-operative inquiry, which was the method used for this inquiry. (Reason, P. 2001 Pp. 560)



Background

In traditional research, the roles of researcher and subject are mutually exclusive. The researcher contributes all the thinking that goes into the project, while the subject contributes the action being studied. In co-operative inquiry these mutually exclusive roles give way to a relationship based on bilateral initiative and control, so that all those involved work together as co-researchers and as co-subjects. As co-researchers they participate in the thinking that goes into the research -- framing the questions to be explored, agreeing on the methods to be employed, and together making sense of their experiences. As co-subjects they participate in the action being studied. The co-researchers engage in cycles of action and reflection: in the action phases they experiment with new forms of clinical practice; in the reflection stage they reflect on their experience critically, learn from their successes and failures, and develop theoretical perspectives which inform their work in the next action phase. (Goswell, M. Motivational 1988. Pp. 122.)

Ideally in co-operative inquiry there is full reciprocity, with each person's agency, their potential to act as self-directing persons, fundamentally honoured both in the exchange of ideas and in the action. This strongly contrasts with traditional approaches in which all agency is held by the researcher and the subjects of the inquiry are treated as objects. Co-operative inquiry is one method of several which are informed by a radical participatory worldview. While there is not the space within this article to explore these issues fully, it should be noted that because of the emphasis on self-reflective agency, this is a method particularly suitable for practitioner research and for the development of innovative approaches to practice.

The inquiry team for this research consisted of the practice GPs and the five complementary practitioners, with the Director of Clinical Research (the author of this article) as facilitator. The inquiry engaged in five cycles of action and reflection between November 1989 and June 1990. Each action phase consisted of two or three clinics attended by up to four patients; each reflection stage consisted of a three hour meeting ...