Accounting for the control of doctors: Management information systems in hospitals

The paper describes some current and proposed innovations in the activity accounting and cost accounting systems in two Swedish hospitals. Results are reported of interviews with administrators and senior doctors which reveal their attitudes and intensions with respect to the new control information generated by the accounting innovations. The fundamental differences between the professional ethos of the doctor and the managerial ambitions of the administrator are found to remain robust. Nevertheless there is evidence that the new control information may be the focus of some genuine convergence in the outlook of some administrators and some “doctors managers” with some consequent reduction in goal-uncertainty in the organisation. This paper argues that this calls for some revision of existing accounts of the interaction of doctors and administrators in hospital management.