Creating “Risky” New Roles in Healthcare: Identities, Boundary-Making, and Skilling Under Rationalization and Consumer Demand

Abstract

Healthcare is experiencing two countervailing pressures: to increase efficiency and be more responsive to consumer demands. Healthcare organizations often create new work arrangements, including “lay healthcare” roles, to respond to these pressures. Using longitudinal qualitative data, this article analyzes how one set of new lay healthcare workers attempted to construct a workplace identity, sell their value to existing professional workers, and navigate the precarious conditions of the new role. The authors find that workers in these new roles faced immense challenges stemming from their positions as “risk absorbers,” which ultimately harmed workers and reduced the efficacy of the new role.