Changes in the relations and roles of doctors and nurses

The present article critically discusses how the relations and roles of doctors and nurses have changed over the last 40 years, and how these have been re-shaped by a growing focus on improving patient care while preserving and improving the economics of the health service. It suggests that the emphasis on more efficiency and more accountability has changed both the roles and span of control of doctors and nurses. Yet, it also argues that stereotypes held by doctors and nurses about one another remain difficult to change. Managers have emerged as new actors in the healthcare system, and have contributed to these role shifts. Overall, the relation between doctors and nurses has changed, over the last 40 years, from being a relation based on status, to a more balanced one, based on mutual trust and leadership, resulting in the emergence of more complex psychological processes between the main actors of the healthcare system.