Identifying the Need Figure Integration of Managerialism and Leaderism in Managing Health Care Organizations: Introducing a New Paradigm by a Scoping Review
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Abstract
In the new century and in the era of post-modernist, managerialism and leaderism theories have replaced the words management and leadership for driving of new public management such as healthcare organizations. each of these two theories cannot be alone successful to managing these organizations. several authors believed the integration of these two discourses can effectively drive healthcare organizations. According to these considerations, the current research was aimed to develop an integrated model of managerialism and leaderism theories among healthcare organizations. This study was a scoping review, conducted from 2000-2024. The data in this study included English articles and documents using related keywords, searched alone and in combination with Boolean operators through six international databases, and google scholar for additional documents. After doing screening and selection process through the PRISMA flow diagram, finally 30 studies as total number selected for in-depth analysis. The results of several studies showed that managerialism and leaderism discourses could not developed health care organizations alone effectively. Therefore, some authors suggested the need to develop leaderism discourses toward managerialism as an integration and combining the strengths of these two theories for managing health care organizations. The fusion of managerialism and leaderism discourses as a paradigm in health care organizations is, in fact, a new public management in the postmodernism era, arising from the converging strengths and the conversion of their own weaknesses and challenges into new opportunities.
1. Azad N, Anderson HG, Brooks A, Garza O, O’Neil C, Stutz MM, et al. Leadership and management are one and the same. Am J Pharm Educ 2017;81:102.
2. Klikauer T. What is managerialism? Crit Sociol 2013;41:1103-19.
3. Doran C. Managerialism: an ideology and its evolution. Int J Manag Knowl Learn 2016;5:81-97.
4. Shepherd S. Managerialism: an ideal type. Stud High Educ 2018;43:1668-78.
5. O’Reilly D, Reed M. The grit in the oyster: professionalism, managerialism and leaderism as discourses of UK public services modernization. Organ Stud 2011;32:1079-101.
6. Zamani A. Providing a structural model of innovation based on leadership styles, organizational commitment and climate in the Iranian National Tax Administration. Q Prof J Soc Sci 2019;13:73-104.
7. O’Reilly D, Reed M. Leaderism: an evolution of managerialism in UK public service reform. Public Adm 2010;88:960-78.
8. Ekman M, Lindgren M, Packendorff J. Universities need leadership, academics need management. High Educ 2018;75:299-321.
9. Klikauer T. A preliminary theory of managerialism as an ideology. J Theor Manag Innov 2019;49:421-42.
10. Raufipour H, Ahanchian MR. Status of human relationships in school management based on postmodern teachings. New Educ Approaches 2007;3:19-40.
11. Smeenk S, Teelken C, Eisinga R, Doorewaard H. Managerialism and organizational commitment. Res High Educ 2009;50:589-607.
12. Lončar D. Postmodern organization and new forms of organizational control. Econ Ann 2005;50:105-20.
13. Melo S, Beck M. Quality management and managerialism in healthcare. Springer; 2014.
14. Tabrizi JS, Haghgoshayie E, Doshmangir L, Yousefi M. New public management in Iran’s health complex. Prim Health Care Res Dev 2018;19:264-76.
15. Kheirgoo M, Danaeifard H. Challenges of public administration in Iranian education. Mil Manag Res Q 2012;11:11-45.
16. Seyed Naghavi M. Organization and management from modernism to postmodernism. Manag Stud Dev Evol 2001;8:167-89.
17. Esfahani MN, Nouri AG. Servant leadership and organizational commitment. Manag Res 2011;4:105-24
18. Johnson J. Health organizations. Jones & Bartlett; 2009.
19. Ilipinar G, Johnston WJ, Montaña J, et al. Design thinking in the postmodern organization. China USA Bus Rev 2011;10:1203-12.
20. Carlisle Y. Complexity dynamics and managerialism in healthcare organizations. J Med Mark 2011;11:284-93
21. Pocklington K, Fullan M, Wallace M. Managing complex educational change. Routledge; 2014.
22. Chaharbaghi K. Provision of public services in an age of managerialism. Equal Divers Incl 2007;26:319-30
23. Arksey H, O’Malley L. Scoping studies. Int J Soc Res Methodol 2005;8:19-32.
24. Corbin J. Basics of qualitative research. SAGE; 2014.
25. Westphal K, Rageczi W, Masotya M, et al. Enhancing scoping review methodology. MethodsX 2021;8:101375
26. Tapanila K, Siivonen P, Filander K. Academics’ positioning toward management reforms. Stud High Educ 2020;45:117-28.
27. Craayenstein MR, Carmichael T, Musson-Craayenstein A. Clinician resistance in NHS hospital. Grounded Theory Rev 2020;19:47-64.
28. Hong QN, Fàbregues S, Bartlett G, et al. MMAT tool 2018. Educ Inf 2018;34:285-91.
29. Stretton T, Cochrane T, Narayan V. Mobile mixed reality in healthcare education. ALT; 2018.
30. Kirkpatrick I, Hartley K, Kuhmannen E, Veronese G. Clinical management and professionalism. Springer; 2013
31. Peters MD, Godfrey CM, McInerney P, et al. JBI reviewers manual. JBI; 2015.
32. Geschwind L, Aarrevaara T, Nordstrand L, Lind J. Academic leadership roles. In: Nordic higher education reforms. Springer; 2019.
33. Karlsson TS. Managerial discretion in public managers. Public Manag Rev 2019;21:315-33.
34. Machin D. Hybrid professional identity in education. Br J Sociol Educ 2018;39:518-34.
35. Tsheola J, Nembambula P. University governance under managerialism. Mediterr J Soc Sci 2014;5:1655-66.
36. Davis A, Jansen van Rensburg M, Venter P. Managerialism and university middle managers. Stud High Educ 2016;41:1480-94.
37. Holkrik M, Dechar N. Values in managerialism and leadership. Int J Leadersh Public Serv 2011:109-18.
38. Von Knorring M, Alexanderson K, Eliasson MA. Healthcare managers and medical profession. J Health Organ Manag 2016;30:421-40.
39. Pollitt C. Managerialism redux? Financ Account Manag 2016;32:429-47.
40. Lynch K. New managerialism and education. Concept 2014;5:11-20.
41. Bresnen M, Hyde P, Hodgson D, et al. Leadership talk and leaderism. Leadership 2015;11:451-70.
42. Reed M, Wallace M. Institutional innovation through discourse. Res Sociol Organ 2015:269-302.
43. Macfarlane B. Challenging leaderism. High Educ Res Dev 2014;33:1-4.
44. Edmonstone JD. Escaping healthcare leadership cul-de-sac. Leadersh Health Serv 2017;30:76-91.
45. Chetty G, Louw T. Managerialism or collegialism in higher education. Int Conf Proc; 2012.
46. Shatil SH. Managerialism: a social order on the rise. Crit Sociol 2020;46:1-8.
47. Louw VN. From public administration to governance. J Public Adm 2012;47:1-10.
48. Van Vugt M, Van Rueden CH. Evolutionary approaches to leadership. Leadersh Q 2020:1-10.
49. Chan A. Surveillance in Hogwarts: managerialism and anarchism. Child Lit Educ 2019;50:417-30.
50. Dargahi H, Ketabchi Khonsari MH. Competency model for lab managers. Lab Diagn 2024;15:49-59.
51. Dargahi H, Ketabchi Khonsari MH, Kooshkebaghi M. Hybrid competency‑meritocracy model. MJIRI 2025;39:34-54.
52. Dargahi H, Lotfi A, Isazadeh N. Cultural management and talent management. Med Spiritual Cultiv 2023:218-32
53. Biglar M, Dargahi H, Ghorbani Z, Garshasbi S. Empowerment training and productivity. J Hosp 2020;19:67-82.
54. Tajvar M. In-service training effectiveness for nurses. Hakim J 2022;25:243-54.
55. Shokrizadeh Arani L, Karami M. IT impacts on health systems. Health Inf Manag 2012;8:835-41.
56. Oliaei S. IT in healthcare system management. J Paramed Sci AJA 2007;2:12-14.
57. Dargahi H, Arabkhani A, Ghorbani R, Roshdi I. Development model for Iran healthcare. J Patient Saf Qual Improv 2023;11:87-102.
58. Bruno A, Dell’Aversana G, Zunino A. Customer orientation and leadership. Front Psychol 2017;8:1920
59. Hozni SA, Hakkak M, Vahdati H, Nazarpouri AH. Clinical leadership competency. Depict Health 2020;11:223-36.
60. Liang Z, Howard P. Evidence-informed decision-making part 2. APJHM 2011;6:12-21.
61. Dargahi H, Darrudi A, Zalvand R. Family medicine SWOT in Iran. Iran J Public Health 2019;48:1140.
62. Shadpour K. Health sector reform in Iran. Hakim Res J 2006;9:1-18.
63. Nasrollapour Shirvani S, Motlagh M, Shariati M, et al. Senior management roles in medical universities. Community Health J 2017;8:1-9.
64. Kakemam E, Dargahi H. Competency gaps in hospital management. J Health Manag 2019;21:451-64.
65. Malek Mohammadi HR, Vahdaninia V. Evolution of health policy in Iran. IJPP 2016;2:73-94.
66. Bagshaw P. Managerialism in NZ public institutions. NZ Med J 2000;113:114.
67. Lankarani KB, Alavian SM, Peymani P. Health challenges in Iran. MJIRI 2013;27:42.
68. Bikmoradi A, Brommels M, Shoghli A, Sohrabi Z, Masiello I. Academic leadership requirements. BMC Med Educ 2008;8:1-7.
69. Kovner AR, Rundall TG. Evidence-based management reconsidered. Front Health Serv Manag 2006;22
70. Giacomelli G, Ferré F, Furlan M, Nuti S. Involving hybrid professionals in management. Health Serv Manag Res 2019;32:168-79.
71. Skela Savič B, Robida A. Middle management capacity in hospitals. Hum Resour Health 2013;11:18.
72. Holder R, Ramagem C. Health leadership and management competencies. World Hosp Health Serv 2012;48:9.
73. International Hospital Federation. Leadership competencies for healthcare services managers. IHF; 2015
74. Kindermann B, Wentzel D, Antons D, Salge TO. Conceptual contributions in marketing. J Mark 2024;88:29-49.
75. Anessi-Pessina E, Cantù E. Managerialism in Italian NHS. Int J Health Plann Manage 2006;21:327-55.
76. Correia T. Managerialism and professionalism in hospitals. Health Sociol Rev 2013;22:255-67.
77. Dieter Mayer IT. New managerialism in education management. J Educ Adm 2002;40:534-55.
78. Harris D. Managerialism and myth in higher education. Power Educ 2011;3:117-27.
79. Beattie B. Managerialism in NSW Health Service. Aust Health Rev 2000;23:170-5.
80. Tsheola J, Nembambula P. Governance and managerialism in SA universities. Mediterr J Soc Sci 2014;5:1655-66.
81. O’Reilly D, Reed M. Professionalism, managerialism and leaderism. Organ Stud 2011;32:1079-1101.
2. Klikauer T. What is managerialism? Crit Sociol 2013;41:1103-19.
3. Doran C. Managerialism: an ideology and its evolution. Int J Manag Knowl Learn 2016;5:81-97.
4. Shepherd S. Managerialism: an ideal type. Stud High Educ 2018;43:1668-78.
5. O’Reilly D, Reed M. The grit in the oyster: professionalism, managerialism and leaderism as discourses of UK public services modernization. Organ Stud 2011;32:1079-101.
6. Zamani A. Providing a structural model of innovation based on leadership styles, organizational commitment and climate in the Iranian National Tax Administration. Q Prof J Soc Sci 2019;13:73-104.
7. O’Reilly D, Reed M. Leaderism: an evolution of managerialism in UK public service reform. Public Adm 2010;88:960-78.
8. Ekman M, Lindgren M, Packendorff J. Universities need leadership, academics need management. High Educ 2018;75:299-321.
9. Klikauer T. A preliminary theory of managerialism as an ideology. J Theor Manag Innov 2019;49:421-42.
10. Raufipour H, Ahanchian MR. Status of human relationships in school management based on postmodern teachings. New Educ Approaches 2007;3:19-40.
11. Smeenk S, Teelken C, Eisinga R, Doorewaard H. Managerialism and organizational commitment. Res High Educ 2009;50:589-607.
12. Lončar D. Postmodern organization and new forms of organizational control. Econ Ann 2005;50:105-20.
13. Melo S, Beck M. Quality management and managerialism in healthcare. Springer; 2014.
14. Tabrizi JS, Haghgoshayie E, Doshmangir L, Yousefi M. New public management in Iran’s health complex. Prim Health Care Res Dev 2018;19:264-76.
15. Kheirgoo M, Danaeifard H. Challenges of public administration in Iranian education. Mil Manag Res Q 2012;11:11-45.
16. Seyed Naghavi M. Organization and management from modernism to postmodernism. Manag Stud Dev Evol 2001;8:167-89.
17. Esfahani MN, Nouri AG. Servant leadership and organizational commitment. Manag Res 2011;4:105-24
18. Johnson J. Health organizations. Jones & Bartlett; 2009.
19. Ilipinar G, Johnston WJ, Montaña J, et al. Design thinking in the postmodern organization. China USA Bus Rev 2011;10:1203-12.
20. Carlisle Y. Complexity dynamics and managerialism in healthcare organizations. J Med Mark 2011;11:284-93
21. Pocklington K, Fullan M, Wallace M. Managing complex educational change. Routledge; 2014.
22. Chaharbaghi K. Provision of public services in an age of managerialism. Equal Divers Incl 2007;26:319-30
23. Arksey H, O’Malley L. Scoping studies. Int J Soc Res Methodol 2005;8:19-32.
24. Corbin J. Basics of qualitative research. SAGE; 2014.
25. Westphal K, Rageczi W, Masotya M, et al. Enhancing scoping review methodology. MethodsX 2021;8:101375
26. Tapanila K, Siivonen P, Filander K. Academics’ positioning toward management reforms. Stud High Educ 2020;45:117-28.
27. Craayenstein MR, Carmichael T, Musson-Craayenstein A. Clinician resistance in NHS hospital. Grounded Theory Rev 2020;19:47-64.
28. Hong QN, Fàbregues S, Bartlett G, et al. MMAT tool 2018. Educ Inf 2018;34:285-91.
29. Stretton T, Cochrane T, Narayan V. Mobile mixed reality in healthcare education. ALT; 2018.
30. Kirkpatrick I, Hartley K, Kuhmannen E, Veronese G. Clinical management and professionalism. Springer; 2013
31. Peters MD, Godfrey CM, McInerney P, et al. JBI reviewers manual. JBI; 2015.
32. Geschwind L, Aarrevaara T, Nordstrand L, Lind J. Academic leadership roles. In: Nordic higher education reforms. Springer; 2019.
33. Karlsson TS. Managerial discretion in public managers. Public Manag Rev 2019;21:315-33.
34. Machin D. Hybrid professional identity in education. Br J Sociol Educ 2018;39:518-34.
35. Tsheola J, Nembambula P. University governance under managerialism. Mediterr J Soc Sci 2014;5:1655-66.
36. Davis A, Jansen van Rensburg M, Venter P. Managerialism and university middle managers. Stud High Educ 2016;41:1480-94.
37. Holkrik M, Dechar N. Values in managerialism and leadership. Int J Leadersh Public Serv 2011:109-18.
38. Von Knorring M, Alexanderson K, Eliasson MA. Healthcare managers and medical profession. J Health Organ Manag 2016;30:421-40.
39. Pollitt C. Managerialism redux? Financ Account Manag 2016;32:429-47.
40. Lynch K. New managerialism and education. Concept 2014;5:11-20.
41. Bresnen M, Hyde P, Hodgson D, et al. Leadership talk and leaderism. Leadership 2015;11:451-70.
42. Reed M, Wallace M. Institutional innovation through discourse. Res Sociol Organ 2015:269-302.
43. Macfarlane B. Challenging leaderism. High Educ Res Dev 2014;33:1-4.
44. Edmonstone JD. Escaping healthcare leadership cul-de-sac. Leadersh Health Serv 2017;30:76-91.
45. Chetty G, Louw T. Managerialism or collegialism in higher education. Int Conf Proc; 2012.
46. Shatil SH. Managerialism: a social order on the rise. Crit Sociol 2020;46:1-8.
47. Louw VN. From public administration to governance. J Public Adm 2012;47:1-10.
48. Van Vugt M, Van Rueden CH. Evolutionary approaches to leadership. Leadersh Q 2020:1-10.
49. Chan A. Surveillance in Hogwarts: managerialism and anarchism. Child Lit Educ 2019;50:417-30.
50. Dargahi H, Ketabchi Khonsari MH. Competency model for lab managers. Lab Diagn 2024;15:49-59.
51. Dargahi H, Ketabchi Khonsari MH, Kooshkebaghi M. Hybrid competency‑meritocracy model. MJIRI 2025;39:34-54.
52. Dargahi H, Lotfi A, Isazadeh N. Cultural management and talent management. Med Spiritual Cultiv 2023:218-32
53. Biglar M, Dargahi H, Ghorbani Z, Garshasbi S. Empowerment training and productivity. J Hosp 2020;19:67-82.
54. Tajvar M. In-service training effectiveness for nurses. Hakim J 2022;25:243-54.
55. Shokrizadeh Arani L, Karami M. IT impacts on health systems. Health Inf Manag 2012;8:835-41.
56. Oliaei S. IT in healthcare system management. J Paramed Sci AJA 2007;2:12-14.
57. Dargahi H, Arabkhani A, Ghorbani R, Roshdi I. Development model for Iran healthcare. J Patient Saf Qual Improv 2023;11:87-102.
58. Bruno A, Dell’Aversana G, Zunino A. Customer orientation and leadership. Front Psychol 2017;8:1920
59. Hozni SA, Hakkak M, Vahdati H, Nazarpouri AH. Clinical leadership competency. Depict Health 2020;11:223-36.
60. Liang Z, Howard P. Evidence-informed decision-making part 2. APJHM 2011;6:12-21.
61. Dargahi H, Darrudi A, Zalvand R. Family medicine SWOT in Iran. Iran J Public Health 2019;48:1140.
62. Shadpour K. Health sector reform in Iran. Hakim Res J 2006;9:1-18.
63. Nasrollapour Shirvani S, Motlagh M, Shariati M, et al. Senior management roles in medical universities. Community Health J 2017;8:1-9.
64. Kakemam E, Dargahi H. Competency gaps in hospital management. J Health Manag 2019;21:451-64.
65. Malek Mohammadi HR, Vahdaninia V. Evolution of health policy in Iran. IJPP 2016;2:73-94.
66. Bagshaw P. Managerialism in NZ public institutions. NZ Med J 2000;113:114.
67. Lankarani KB, Alavian SM, Peymani P. Health challenges in Iran. MJIRI 2013;27:42.
68. Bikmoradi A, Brommels M, Shoghli A, Sohrabi Z, Masiello I. Academic leadership requirements. BMC Med Educ 2008;8:1-7.
69. Kovner AR, Rundall TG. Evidence-based management reconsidered. Front Health Serv Manag 2006;22
70. Giacomelli G, Ferré F, Furlan M, Nuti S. Involving hybrid professionals in management. Health Serv Manag Res 2019;32:168-79.
71. Skela Savič B, Robida A. Middle management capacity in hospitals. Hum Resour Health 2013;11:18.
72. Holder R, Ramagem C. Health leadership and management competencies. World Hosp Health Serv 2012;48:9.
73. International Hospital Federation. Leadership competencies for healthcare services managers. IHF; 2015
74. Kindermann B, Wentzel D, Antons D, Salge TO. Conceptual contributions in marketing. J Mark 2024;88:29-49.
75. Anessi-Pessina E, Cantù E. Managerialism in Italian NHS. Int J Health Plann Manage 2006;21:327-55.
76. Correia T. Managerialism and professionalism in hospitals. Health Sociol Rev 2013;22:255-67.
77. Dieter Mayer IT. New managerialism in education management. J Educ Adm 2002;40:534-55.
78. Harris D. Managerialism and myth in higher education. Power Educ 2011;3:117-27.
79. Beattie B. Managerialism in NSW Health Service. Aust Health Rev 2000;23:170-5.
80. Tsheola J, Nembambula P. Governance and managerialism in SA universities. Mediterr J Soc Sci 2014;5:1655-66.
81. O’Reilly D, Reed M. Professionalism, managerialism and leaderism. Organ Stud 2011;32:1079-1101.
| Files | ||
| Issue | Vol 64 No 2 (2026) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/acta.v64i2.21527 | |
| Keywords | ||
| Managerialism Leaderism New public management Health care organization Discourses Theories | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Dargahi H, Seyed Mahmoudi M, Abolhasanbeigi Gallehzan N. Identifying the Need Figure Integration of Managerialism and Leaderism in Managing Health Care Organizations: Introducing a New Paradigm by a Scoping Review. Acta Med Iran. 2026;64(2):45-57.
