Nature and nurture: the enabling role of low-status professionals' jurisdiction for micro-institutional change in professional organizations

Purpose Changes in regulation systems make professional organizations more likely to undergo rapid, profound and radical change. The issue of how micro-institutional change in professional organizations can be carried out is somewhat ignored. Design/methodology/approach We conducted a process study of a primary hospital in China to trace a pathway through which low-status professionals successfully proceed with radical change at the micro-level. Findings We present a model involving three strategies that, reconfiguring jurisdictional boundaries in combination, activate low-status professionals' long-standing implicit jurisdictions: expertise redefinition, value reorientation and promotion. Research limitations/implications Our study contributes to understanding how low-status professionals reconcile needs for change with contradictions from the core attributes and ambiguities of professional work. Rather than mixed practices enhancing the role of dominant professions, a desire to separate jurisdiction space opens up the access of newly dominant experts. Originality/value Changes in the regulation system make professional organizations more likely to undergo rapid, profound and radical change. The issue of how micro-institutional change in professional organizations can be carried out is somewhat ignored.