Constrained leader autonomy: You are the stoker in hell—No matter what you do,you are wrong!

Abstract

This study explores how formal leaders at various levels experience and respond to exercising their own autonomy in relationships with superiors and staff in a knowledge-dominated healthcare organization. Proposing the notion of constrained autonomy, the study suggests a way of understanding how formal leaders in mid-level positions work within autonomy–authority tensions. Based on interviews with formal leaders, I argue that formal leaders are highly aware of and deal with the autonomy tensions that occur in contradictions between structural requirements, ability to lead, and decision-making power in such complex ways that tensions are upheld and left more ambiguous than they first appeared. Thereby, the study develops literature on autonomy tensions and leadership. It also contrasts research suggesting that formal leaders sometimes deny tensions, are unaware of them, or seek to control or eliminate them and questions the sharp division between autonomy and authority often found in literature. The notion of constrained autonomy may also assist formal leaders navigate daily workplace tensions in knowledge-dominated healthcare contexts.

Keywords

Authority autonomy critical incident method feelings knowledge-dominated work leaders tensions

Introduction

You are the stoker in hell. […] No matter what you do, you are wrong! Because there are always tensions between the professional fields and the leadership field. They clash all the time. This is not a factory, here you work with people. You do not work with parts or canned food that are products, right, and blah blah blah, it is people, all the time. […] I have created myself a lot of space, because I have been very clear in my positions. (Lisa, interviewee)

The quote above is taken from an interview with a formal leader in a knowledge-dominated organization—a large public healthcare organization. Lisa was telling me about the challenges of being a leader in a setting where professional values and the requirements enabling freedom in prioritizing work contrast with ideas of control and top-down line leadership. Implicit in her comment is the tension between autonomy and authority; she is expected to have authority and power, but because her employees are highly educated and knowledgeable healthcare professionals, they also want opportunities to make decisions. So, whatever she does, she feels she cannot win. Dealing with demands for autonomy from below and having expectations regarding loyalty and authority from above means that for formal leaders, exercising autonomy is accompanied by ongoing tension in knowledge-dominated organizations (Alvesson and Blom, 2015; Alvesson et al., 2017; Harding et al., 2014).

The study fills an important research gap by examining how mid-level formal leaders in a knowledge-dominated organization in healthcare experience and respond to issues in exercising their own autonomy through relationships with superiors and staff. Professional autonomy has taken center stage in these settings because of the continuing challenges it poses for healthcare reforms, improving quality and patient safety, cost containment, and resource allocations (Byrkjeflot and Jespersen, 2014; Denis et al., 2010; Freidson, 2001; Harding et al., 2014; Jespersen, 2005; McGivern et al., 2015; Raelin, 1989). Because of this, formal leaders need to seek cooperative and collaborative relationships with healthcare professionals. But formal leaders also have to exercise authority, as legitimately required by their positions, and thus need to seek cooperative and collaborative relationships with superiors. How formal leader autonomy–authority relationships play out with both staff and superiors is therefore an important issue for healthcare organizations. Yet, the question of what constitutes leaders’ autonomy is a neglected topic in healthcare settings and in research on “leader”/“follower” dynamics and relationships. While formal leaders in mid-level positions have not been neglected in research on health, leadership, and organizing (Arman et al., 2012; Harding et al., 2014; Kempster and Gregory, 2017; McGivern et al., 2015; Spurgeon et al., 2015; Stohl and Cheney, 2001), their autonomy-dilemmas, paradoxes, and tensions remain under-researched and theorized. This neglect may have significant consequences for leadership and organizational development (Jarzabkowski and Lê, 2017; Smith and Lewis, 2011), and formal leaders must learn to navigate everyday tensions to not feel like “stokers from hell.” As such, an empirical study will help advance understanding and facilitate the development of theory (Carroll et al., 2008; Raelin, 2011; Tengblad, 2012).

To study the intricacies around autonomy in this context, I interviewed formal leaders from four levels of a healthcare organization. Based on thematic analysis (Braun and Clarke, 2006), I developed the notion of constrained autonomy to highlight how formal leaders at various organizational levels work within tensions, i.e. finding a balance between areas where they can exercise autonomy and where they cannot, sometimes creating new possibilities for autonomy for themselves and sometimes providing more staff autonomy.

The paper is structured as follows. I begin with a description of the research context. Then, I discuss leadership tensions in mid-level positions and provide a conceptual discussion of autonomy, authority, and leadership challenges. After the “Research design and method” section describing the participants, interview practice, and approach to reduce the interview material into overall themes, I analyze the interviews and develop and discuss the notion of constrained autonomy.

Context

The purpose of this study was to explore how formal leaders at various organizational levels experience and respond to issues in exercising their own autonomy through their relationships with superiors and staff. I conducted 17 in-depth interviews with formal leaders of a public healthcare organization in Norway. The study was part of a larger exploration of leadership challenges in large and small, public and private knowledge-dominated organizations.

Healthcare organizations in Norway are comparable to other Western healthcare organizations; they need to adhere to governmental regulations, employ various groups of health professions, and struggle with implementing values of new public management (e.g. Byrkjeflot and Jespersen, 2014; Døving et al., 2016). In line with studies conducted in other countries (Arman et al., 2012; Byrkjeflot and Jespersen, 2014; Denis et al., 2010; Freidson, 2001; Harding et al., 2014; Spurgeon et al., 2015), Norwegian healthcare organizations have also been identified as especially challenging settings for formal leaders and as sites for various tensions (e.g. Grund, 2016; Kjekshus, 2016; Torjesen et al., 2011). Part of these tensions stems from the decision to combine administrative, economic, and professional functions in one role, necessitating a strengthening of formal hierarchy, and from the fact that some formal leaders in Norwegian healthcare may have non-clinical/medical backgrounds.

I use the term formal leader to represent interviewees who had the word leader in their job title and/or talked about it as such. While some studies argue for a clear division between management (manager as coordinating/controlling), leadership (leader as inspirational), and power (dictator as using force) (Alvesson et al., 2017), management and leadership are “often interwoven” (Collinson, 2014: 37) in practice, and they may also be understood as forms of power. Additionally, in the Norwegian healthcare context, formal leader positions include responsibility for leadership/management, professional fields, and budgets. It therefore makes sense to use the term formal leader in this study. However, the use of terms and responsibilities included in formal positions may differ across contexts and countries (Spurgeon et al. (2011) and Spurgeon et al. (2015)). Therefore, I emphasize autonomy tensions as a general leadership problem and detail how these tensions are often “knotted” constructs (Sheep et al., 2017).

Leader autonomy and authority

Tensions in organizational life of leaders

Formal leaders in mid-level positions are likely to experience autonomy-related tensions due to paradoxes in organizational structures (Balogun, 2003; Jarvis, 2012; Stohl and Cheney, 2001). In their vertical and hierarchical relationships, formal leaders often “get caught between their subordinates and the needs of upper management” (Martin, 2004: 149, citing Putnam (1986)). Managing vertical relationship requires formal leaders to coordinate, communicate, and make sense of information and of initiatives (Balogun, 2003; Balogun and Johnson, 2004). While this may facilitate communication “between the operating and top levels of management” (Floyd and Lane, 2000: 158), it may also block organizational development and change (Huy, 2002) and result in challenges as knowledgeable individuals may find such efforts irrelevant or in opposition to their professional knowledge, norms, and values (Alvesson and Blom, 2015; Alvesson et al., 2017; Denis et al., 2010; Freidson, 2001; Jespersen, 2005; Raelin, 1989).

Focusing on the vertical relationships between formal leaders, a number of studies have highlighted how tensions may result in complex ethical dilemmas, such as having to choose between one’s personal morals and complying with the expectations of upper leaders while also keeping the organization’s interests and image in mind (e.g. Dean et al., 2010; Kälvemark et al., 2004; Kempster and Gregory, 2017). The literature on organizational change, strategy, and performance describe autonomy-related tensions and stress as arising due to the contradictory functions of formal leaders in mid-level positions who are important for the implementation of changes, strategies, and plans, but who have limited autonomy (Belasen and Belasen, 2016; Birken et al., 2012; Conway and Monks, 2011; Fleming and Spicer, 2014; Floyd and Lane, 2000; Huy, 2002; Rouleau, 2005).

Intersecting vertical and horizontal relationships may also create issues for formal leaders in terms of identity-related and positional struggles (Stohl and Cheney, 2001). Harding et al. (2014: 1213) show how middle managers find themselves dealing with contradictory subject positions and that they “are both controlled and controllers, and resisted and resisters.” Focus has also been directed to identity tensions arising when professionals move into formal leader positions and become “hybrids” (Byrkjeflot and Jespersen, 2014; Croft et al., 2015; Fulop, 2012; Harding et al., 2014; McGivern et al., 2015; Spehar et al., 2015; Spyridonidis et al., 2015). Scholars have pointed to identity tensions arising when professionals embrace managerial, entrepreneurial, or calculative discourses (McGivern et al., 2015: 413). Navigating several roles may affect how leaders make decisions, lead, and experience tensions, inspiring studies to focus on leaders’ emotional management of complex paradoxes (e.g. Croft et al., 2015; Gardner et al., 2009; Gunnarsdóttir, 2016; Huy, 2002; Kempster et al., 2019).

Despite research on the autonomy-related tensions of formal leaders, how leaders themselves struggle with their own autonomy and how this relates to leadership in knowledge-dominated organizations is empirically underexplored. In particular, how the autonomy–authority dilemmas, paradoxes, and tensions of formal leaders in mid-level positions play out in their relationships with professional staff and with superiors in healthcare organizations remains under-researched.

Understanding autonomy, authority, and leadership

Autonomy is typically understood in terms of freedom, independence, and capacity to self-govern (Alvesson et al., 2017). Authority, on the other hand, normally refers to the accepted and legitimized power someone can exercise (Weber, 1978a, 1978b), i.e. “the ‘right’ one individual has to direct the actions of another” (Ladkin, 2015: 16). From a leadership perspective, autonomy is often linked with the struggles of people in mid-level positions to self-govern and be independent of interference from above, while authority may be associated with a formal leader’s capacity to give instructions to subordinates.

Autonomy–authority tensions arise when formal leaders exercise their authority downwards while their knowledgeable staff require freedom, leeway, and control over their work based on their expertise and experience (Alvesson and Blom, 2015; Costas and Kärreman, 2016). These tensions have been linked with structure, agency, and power struggles (Collinson, 2014; Stohl and Cheney, 2001), because staff enact their agency and power rather than passively accepting formal authority (Rost, 2008; Tourish, 2014). This has led to the understanding that the term “follower” is less appropriate in knowledge-dominated settings.

Autonomy–authority tension becomes “knotted” (Sheep et al., 2017), when one considers that formal leaders may also have to report to someone above them. Acknowledging that staff may need more autonomy than the formal mid-level leader can provide given the constrains of hierarchy and positional authority, formal leaders may seek to construct more autonomy to have greater ability in handling their staff’s requirements. Consequently, they may also engage in autonomy–authority struggles with their superiors as they try to gain the autonomy to deal with claims for autonomy from their staff. I suggest that in these mid-level positions, autonomy and authority are particularly intertwined as leaders try to manage the demands of their superiors and their staff. The quote from Lisa above highlights this complex struggle and tension to which she responds in terms of “creating space.”

Research design and method

Participants

As mentioned in the introduction, the present paper builds on interviews with formal leaders at various levels in a Norwegian healthcare organization. Table 1 provides an overview of the groups of formal leaders I interviewed.

Table 1.

Overview of participants.

Interviews with formal leaders	Hierarchical role	Educational backgrounds
The director and top-level team (Total: 3 people)	They lead the clinic, which is a focus area within a healthcare organization such as medical, surgical, or renal. For anonymity reasons, the exact type of clinic is not specified. However, autonomy struggles are likely to occur despite differences in work, roles, and type of professionals working within different clinics.Department leaders are responsible to the director and top-level team.	Most people from the top-level team had health-related backgrounds. One was a doctor.
Department leaders(Total: 3 people)	Departments were formed around specific work areas within the clinic.Doctors and other specialists are responsible to department leaders.	All had health-related backgrounds. One was a doctor.
Assistant leaders(Total: 3 people)	Responsible for daily work, strategy implementation, developing new suggestions, but no official (though in some cases practical) personnel responsibility.	All had health-related backgrounds. None were doctors.
Team leaders(Total: 8 people)	Teams were of specialized work areas within departments.Nurses and other care staff are responsible to team leaders.	All had health-related backgrounds. None were doctors.

The interviews lasted one to three hours, and except for one Skype interview, all interviews took place in the leaders’ offices at the clinic. I employed the critical incident technique (Butterfield et al., 2005) whereby interviewees recall specific, recent experiences. Because the formal leaders related to instances when they felt they acted effectively or ineffectively, the interviews can best be described as reflective conversations based on a few open questions around leadership experiences in knowledge-dominated contexts. Taking this approach ensured that I got to hear participants’ ideas about leadership and their experiences with leadership linked to everyday activities. Utilizing this interviewing practice and logic of discovery (Locke, 2011) allowed issues to emerge naturally in relation to autonomy, authority, and leadership.

I recorded the interviews, and in my transcriptions, I indicated raised voices with italics and commented on other elements such as laughing, sighing, and use of irony in brackets. Noting such expressions directed my analysis toward leaders’ feelings. Most of the interviews included humor and irony, and some became emotional. As such, I gained rich material, which further confirmed that tensions, feelings, and frustrations are a highly relevant topic in leadership.

Data analysis

I took an inductive thematic analysis approach to analyzing the data (Braun and Clarke, 2006), focusing on the feelings and tensions formal leaders expressed around autonomy. Thematic analysis worked well for the present study because it helped identify, order, and interpret the multiple comments and observations of participants and thereby reduce the interview material into overall, emerging themes (King and Brooks, 2017).

I transcribed all interviews with leaders, noting sentences, words, and tensions that related to autonomy. These included feelings of frustration, challenges around decision-making and responsibilities, hierarchical boundaries, economic constraints, and power of knowledgeable staff. After transcribing all the interviews, I identified general similarities and differences across interviews and produced a list of potential emerging autonomy-related themes for each leader group. Many themes of each organizational level overlapped, such as the differing expectations of “good” leadership, the emphasis on hierarchy and organizational structure, and challenges in leading knowledgeable staff.

I uploaded all interview transcripts to the qualitative analysis software MAXQDA. The software’s coding and color-marking tools assisted me in ordering the possible themes into more defined themes with sub-themes and connections/overlap with other themes. I coded each formal leader’s feelings of restriction in autonomy and challenges regarding their authority, then coded each leader’s response to (how they dealt with) struggles in exercising autonomy. This included sometimes being disloyal or unfaithful to the communication line inherent in the formal organizational hierarchy and not implementing all the rules stemming from the government’s steering documents.

Third, I went through all these preliminary, initial codes, re-coding and refining them into clearly defined themes. Once I had coded all the interview transcripts this way, I ended up with nine clearly defined themes based on all the interview transcripts. Looking for patterns and insights that would help in understanding how formal leaders at various organizational levels experience and respond to exercising their own autonomy, I examined how formal leaders at each of the four organizational levels experienced autonomy in terms of “upward” and “downward” tensions and how they handled these. I compared their experiences across levels. This highlighted that formal leaders’ struggles around autonomy and what they referred to as leadership were highly complex or “knotted” (Sheep et al., 2017). As such, autonomy struggles seemed to be linked with tensions between leadership and structure, leadership and power, and power and structure. In this way, three themes—hierarchy/structural requirements, limited ability to lead, and reduced formal leader power—emerged from the interview material in relation to autonomy–authority tensions.

Autonomy tensions around structure, leadership, and power

The following themes represent what was said across interviews and thus represent the experiences of all participants. Use of pseudonyms and other similar anonymizing actions are noted. The analysis is organized according to the themes, the tensions between them, and around the four organizational levels. For an overview, the three main themes and how they play out across the four organizational levels are summarized in Table 2.

Table 2.

Overview of main themes.

Main themes		Tensions across organizational levels
Theme 1: Hierarchy/structural requirementsTheme 2: Limited ability to lead	>	Tensions often expressed as issues around loyalty and line leadership.
Theme 2: Limited ability to leadTheme 3: Reduced formal leader power	>	Tensions often expressed as challenges with decision-making.
Theme 1: Hierarchy/structural requirementsTheme 3: Reduced formal leader power	>	Tensions often expressed as issues around prioritizing and developing ideas.

Hierarchy/structural requirements and limited ability to lead: Loyalty and line leadership tensions

This section focuses on formal leaders’ experiences of tensions between hierarchy/structural requirements and limited ability to lead—often expressed as issues around loyalty and line leadership.

Top-level leaders

One of the top-level leaders, Chris, highlights how hierarchy/structural requirements contradict ability to lead. This created tensions that constrained Chris’ autonomy:

[…] we can develop routines and procedures, and practices, and so on, but it must always be within, it cannot go beyond the Occupational Health Act or [other acts] other laws or agreements that exist in, exist in Norway, so eh (sighs). And usually, that’s enough room for you to lead properly, well, yes […] I have employed the department leaders to assist me in this responsibility, right […] departments, like the line, er, leaders.

Not only are the overall goals, rules, and principles of work set centrally, Chris and other top-level leaders are also expected to lead accordingly. The word “usually,” the sigh, Chris’s tone of voice and body language indicate that loyalty to the CEO’s and the board’s guidelines, and other acts and laws constrained Chris’ own discretion to set the agenda and enact leadership. While this is a tension normally experienced in mid-level positions (Balogun, 2003; Balogun and Johnson, 2004), it also constrains the autonomy of top-level leaders. While Chris and other top-level leaders emphasized how they delegated some of their autonomy and authority to department leaders to deal with overall hierarchy/structural requirements, and while this seemingly indicated more autonomy given to staff, top-level leaders also instilled the idea of line leadership and thus continue expectations of loyalty from their own staff.

Department leaders

Like top-level leaders, department leaders were constrained by hierarchy/structural requirements and tensions arising in relation to these requirements. For example, Rene says:

I may, well, I can find myself in a situation where I can say to [top-level leader] that I disagree […] but I do what [top-level leader] tells me to do. I cannot be disloyal to [top-level leader] and say, er, pretend that I agree and then go and do something different. That is disloyal.

This quote shows how the need to be loyal to the superior and the organizing principle of line leadership come at the expense of Rene’s own freedom to decide what is best for the department and staff. In dealing with this struggle, Rene constrains his own autonomy with what to say and how to behave, to be perceived as loyal. As such, the quote highlights a classic paradox between structure and the ability to make one’s own evaluations and lead (Balogun, 2003; Jarvis, 2012; Stohl and Cheney, 2001). Since Rene’s disagreement here was out of concern for staff, the quote can also be understood in terms of him being caught between the needs of subordinates and that of higher-level leaders (Martin, 2004). As the disagreement is followed up with loyal subordination, autonomy is functionally constrained (e.g. Belasen and Belasen, 2016; Birken et al., 2012; Conway and Monks, 2011; Floyd and Lane, 2000; Huy, 2002; Rouleau, 2005).

Assistant leaders

Assistant leaders were employed to help department leaders in their daily work. Assistant leaders were therefore responsible for strategy implementation and the development of new suggestions, but they had no official (though in some cases practical) personnel responsibility. Assistant leaders also emphasized that loyalty and line leadership function as a structural constraint on their autonomy. As Simon puts it:

There are things that are decided in the leader line above me that I have to relate to, and which constrain my autonomy. It is producing a frame around what I’m allowed to do […] But er, one goes on the side of line-leadership in order to create maneuvering-room. A little more autonomy, er, er […] And after having worked in the system for a while, one will have created some networks and contacts. Er, and when we wanted to do something which was, should I say, more than we ought to do […] Had I kept to the line, I’m unsure if I had been given the room to do everything we wanted to. But then it’s about using the network, trying from different angels […] and yes, start some projects, apply for funds, and open for more opportunities […] Then one creates more opportunities […] So, one can, once in a while, go outside the line (smiles) without er, being disloyal to one’s closest leader, but, but, er, using resources a little more creatively.

Feeling their freedom constrained by the expectations of department leaders and top-level leaders and by the structural and political interests they represented, assistant leaders sought to create more autonomy for themselves by sidestepping the line leadership principle. This technically introduced a breach of the loyalty they were expected to show. However, framing such actions as being in the interest of the organization in terms of generating more opportunities, as an efficient way to start new projects, and attracting more funds, “going outside the line” was reframed as creative and creating room to maneuver. This suggests a twist to the classic power-relations between staff and formal leaders (Balogun, 2003; Jarvis, 2012; Stohl and Cheney, 2001), and shows how constrains are dealt with by creating more tension around autonomy, and through this, generating room to maneuver. In this case, tensions were kept high, as both upper-level leaders and staff saw the efficiency of going outside the line: upper-level leaders could not formally endorse it and assistant leaders allowed it to happen but hid it from their superiors.

Team leaders

Elizabeth also felt that structural requirements clashed with how she preferred to enact leadership. This clash was enforced and influenced by the knowledge-dominated context in which she was supposed to lead:

Leadership in my position, that’s er (pause) yes, so I receive demands. I have to deal with that. And then it’s making the best of it. I have a very small space for my own […] I am very aware that er, I am a leader, I am not a chief. I am completely aware that the staff has lots, lots of responsibility. I don’t follow them like a hawk and watch and see that they do the things they should. I have an expectation that, er, things will be done and that once we have decided that it should be solved that way, it will be […] It’s quite hard to endure as leader, and the team is very strong. Often, small subgroups emerge in the team […] If you then come in as a leader at my level and think, here I’M the chief, it’s me, then you’ll quickly meet resistance. But I come in […] I think it’s okay to lead. Lead in the right direction.

Experiencing her autonomy as a “very small place,” Elizabeth highlights her in-between position. She feels caught between the power of upper leaders which constrains what she can do, and the power of “strong” staff which constrains how she can lead (Alvesson and Blom, 2015; Blom and Alvesson, 2014; Collinson, 2005, 2014; Hollander, 1993). Dealing with these contrasts, Elizabeth and other team leaders sought to avoid micro-management. “Not watching them like a hawk” may minimize conflict from below, as it creates more space for staff—wanting them to feel more autonomous. Taking this approach indicates that Elizabeth may find it easier to deal with superiors above her, than risking conflict from powerful staff below, who may challenge and resist overly controlling leadership. It also suggests a tension between needing legitimacy from staff and being dependent on them to carry out the work of team leaders. As such, loyalty and line leadership tensions are kept in play by constructing other autonomy- and leadership-related tensions.

Limited ability to lead and reduced formal leader power: Decision-making challenges

This section focuses on formal leaders’ experiences of tensions between limited ability to lead and reduced formal leader power—often expressed as challenges with decision-making.

Top-level leaders

Top-level leaders highlighted that decision-making had its challenges. Chris explains why:

The leader team has much more power than I alone, even if it apparently seems as though I have all the power. Because I make decisions. But I make decisions based on a discussion in this team. Because it would be very scary if I started making decisions on my own, which influenced those [working here and our patients], because you need a professional insight to make sensible decisions. So, I lean heavily on them.

Here, Chris contrasts formal positional power with the power of the leader team. While this highlights a focus on the positive consequences of shared power (which in practice means reduced formal power), Chris also emphasizes how the leader team provides professional advice Chris is expected to be responsive to, even if not fully convinced by the advice. Hence, Chris’ formal autonomy to make decisions is reduced. Responding to this, Chris is not concerned with removing or managing this tension; rather, it is upheld by the talk about the need for professional insights.

Despite this decision-making process, formal decisions sometimes led to “fights”—a word used by Chris and other top-level leaders—between formal leaders, knowledge-workers, and unions:

They try to squeeze in all possible ways, er, for them to get [specific work-rights]. So then, then, it is a squeeze between, should we hold on to the overall goal of [organizing principle] or in some way consider [doing as the knowledge-workers wants] … And now they have won the case in the labor court […] Er, so that’s a dilemma. We have different interests.

This quote presents staff as powerful agents who can use the formal labor system to engage in agenda-setting (Alvesson and Blom, 2015; Alvesson et al., 2017; Collinson, 2005; Mintzberg, 1998; Putnam et al., 2016; Tourish, 2014). Second, it underscores that even top-level leaders may be challenged and feel squeezed by the exercise of such power, and that decision-making is a matter of balancing many different expectations from above and below. Third, it highlights how Chris, and other top-level leaders framed and dealt with challenges; they were considered fights between enemies that either leaders or staff would win. In the case above, top-level leaders saw their decisions, which were already constrained by upper-level political regulations, overthrown by knowledge-workers and unions. Hence top-level leaders’ autonomy and power to make decisions was not always functionally effective, even if they had some formal power and worked within the laws, guidelines, etc.

Department leaders

Similar dynamics were at play for department leaders. Hannah explains how decisions need to be developed based on the expertise of knowledge-workers, which meant that her own leader autonomy and discretion in decision-making was limited:

In that process, because it’s a process when you are going to develop a decision […] you must be very responsive to the employees and confirm that they come with nuances and improvements to your decision. And it must be noted that this was something you said, it was your idea, it was a really good idea. You must not steal it.

Hannah highlights a contradiction between her formal decision-making power and the expertise of knowledge-workers. Having to involve knowledge-workers to ensure quality and efficiency and counter potential conflicts, Hannah’s formal leader power is reduced as participative. Her power and autonomy are further reduced by the need to ensure that knowledge-workers are credited for their ideas and decisions in the process, meaning that Hannah’s part in decision-making needs to look responsive. In this sense, she constrains herself.

However, this style of leading contrasted with the principle of line leadership meant to install leadership effectiveness and control. As department leaders had to yield to be responsive to staff’ expertise, and not to be perceived too authoritarian, it created complex, interrelated, and overlapping tensions (Sheep et al., 2017) between hierarchy/structural requirements, differing leadership ideas, and limits to formal leader power. Constraining one’s own autonomy, department leaders upheld autonomy tensions and constructed leadership as a complex process for keeping tensions in play rather than controlling, eliminating, or denying them.

Assistant leaders

Simon also describes how his ability to lead and his decision-making power are challenged by the expertise and power of knowledge-workers, who want a say in decision making. Other assistant leaders reported similar experiences. As a result, they emphasized how they spent a great deal of time having conversations with and cautiously caring for their relationships with staff. However, this “relational approach” was difficult because of the loyalty expectations of upper leaders, and Simon found himself pressured to enact more controlling forms of leadership:

I really stood there alone and felt that I enacted leadership in standing there, talking to those who were there, er, accomplishing some meetings where they could bring their stuff and, and, and, but sticking to the decision that was made. That direction and in no way shy away from it, despite their frustration.

Decision-making and the leadership struggles of assistant leaders resulted from having to navigate the expectational and regulative pressure from leaders above and having to mitigate resistance and conflicts with the staff below. Assistant leaders thus found themselves positioned in-between these forces and expectations (Floyd and Lane, 2000; Martin, 2004), leading to autonomy frustrations around their own ability to lead and use their formal power. In this, they felt alone—fearing the loss of acceptance and legitimacy from above and below. However, Simon and other assistant leaders chose to work within the tensions, not choosing a side, not eliminating or solving them. Instead, leading was constructed as the ability to uphold ambiguity—to work with contradicting expectations and frustrations.

Team leaders

Team leaders also needed to consult with staff before thinking about deciding (or implementing) anything. Michael explains how this constrained his autonomy to make decisions and influenced his ability to lead:

Professionally, I have the knowledge to make a decision, and it will be appropriate and reasonable. But then I lose, I will never be able to make it work […] So strategically, I have to go the rounds of discussion […] So I must, so I must, if you as a leader at a lower level which I am here do not have any support in the organization, you are finished.

Michael follows the strategy of other leaders in the organization. He is open to active participation and consensus-building around decision-making, as he is dependent on the expertise of the knowledge-workers and he would otherwise be perceived as too authoritarian, which is a recognized way for people in mid-level positions to move things forward (Jarvis, 2012). Michael and other team leaders also stressed how often their own professional knowledge had to be put aside in the decision-making process. Thus, team leaders were highly aware of the tensions between formal positional power, professional expertise/power of leaders, and expertise/power of staff. They dealt with these tensions by temporarily letting go of their formal and professional expertise and autonomy—restraining themselves but also being strategic, e.g. working within the tensions to make decisions. While this may be a necessary process to reach the goals set in the leader line, getting there involved a possible breach of loyalty (opening for discussions and potentially moving away from the overall direction). As indicated by Lisa in the paper’s opening quote, being wrong seemed unavoidable, and instead of seeking to manage these tensions, team leaders upheld them, thereby creating “knots” (Sheep et al., 2017). This occurs in the power of upper-level leaders to decide on goals conflicting with their ability to make better decisions, between loyalty to line leadership versus their need to be responsive to the expertise of staff, and in their own expertise and formal power to decide versus knowledge-workers’ expertise and power—which they use strategically to create room to lead.

Hierarchy/structural requirements and reduced formal leader power: Issues around prioritizing and developing ideas

This section focuses on formal leaders’ experiences of tensions between hierarchy/structural requirements and reduced formal leader power—often expressed as issues around prioritizing and developing ideas.

Top-level leaders

In this study, hierarchy/structural requirements constrained top-level leaders’ autonomy in terms of their freedom to prioritize and organize. Chris, a top-level leader says:

I have been delegated authority from the CEO to take responsibility for the [organization] within a budget-frame, right. So, if I keep budgets and do the assignments we have got from – we receive an assignment document from the Ministry of Health […] Then, in the assignment document, there will be something about [specifies tasks] that we must do. And then there will also be employer and HSE requirements and all that […] But within that, right, er, I feel that I have a relatively large freedom to exercise leadership.

This quote highlights how goals and organizing principles are externally set. Considering the public healthcare context, it is not surprising that leaders need to act within political regulations. However, top-level leaders are normally associated with the autonomy to, for example, set goals, define strategies, and interpret and implement regulations (Martin, 2004; Roness et al., 2008). Chris’ quote highlights how this autonomy is reduced through hierarchy/structural regulations—which is somewhat contradictory because formal leader power is also deferred from hierarchy/structural arrangements. Such requirements created reductions in power and loyalty tensions; top-level leaders needed to act authoritatively and autonomously within structural and organizational constraints. Such constrains may be common in mid-level positions (e.g. Balogun, 2003; Balogun and Johnson, 2004; Conway and Monks, 2011; Floyd and Lane, 2000; Wooldridge et al., 2008), but in this study, top-level leaders reported dealing with these tensions by constructing some freedom to lead within the existing tensions, thus upholding the tensions but downplaying their constraining and details. Not questioning the centrally set goals and not being disloyal, top-level leaders seemed to think that they could gain autonomy by meeting the set measures—perhaps, for example, in terms of less control and follow-up actions from the CEO.

Department leaders

Tensions between hierarchy/structural requirements and formal power caused frustrations among department leaders, as it squeezed their autonomy to prioritize ideas and values and develop suitable leadership. Nora highlights this in the following quote:

[…] my leader is engaged with economy. But we need to get things going. And then, we have professionals and values, ethics and moral things become, then one really becomes the middle between the bark and the tree […] But that’s where I think, if you spend a little bit of time, if you start in the small […] think a little and go some rounds and look at what you can you do. Just to get someone with me, so that it does not create a huge resistance. Because it’s a bit like that, I think sometimes you must choose your fights, so that’s what I’m doing now.

As the quote highlights, department leaders had to work within centrally set strategies, goals, and budgets, which constrained their ability to prioritize, decide, and act as required to “get things going.” The ethics of professionals also imposed a constraint on the decisions of department leaders. Experiencing pressure from above and below, department leaders felt trapped “between the bark and the tree” and thus unable to maneuver autonomously. Here, “choosing your fights” became a way to navigate tensions. As such, the complex, ambiguous tensions are upheld and within these, department leaders created ways to navigate them—not eliminating or solving them.

Assistant leaders

While assistant leaders felt constrained in decision-making and had to shape their leadership to adhere to the principle of line leadership, they felt even further constrained by their limited power to prioritize initiatives and develop the organization and their teams as they deemed necessary. For example, Kelly said the following:

I often feel so frustrated working in [organization]. I feel, I’m so [swears] tired that HR does not help […] Right, I get so [swears] tired from feeling that, yes, I feel I will never be able to hire anyone as long as HR have the power, they have […] But with patient cases (pause), I trust the specialist. And then I put the responsibility back to the specialist and say that […] I am responsible for operations, I’ll take care of this, but this man is paid more than me to take the professional responsibility.

Kelly highlights the challenges of working within an organizational structure designed so that assistant leaders are often figureheads (Balogun and Johnson, 2004). Having to comply with the strategies set by upper-level leaders (vertical power relations), assistant leaders needed to ensure top-quality work within the team—which required the employment of highly skilled staff. But while formal leaders are generally expected to be able to hire and fire, assistant leaders did not have this power. This was the responsibility of HR (horizontal power relations). However, according to assistant leaders, HR seemed more concerned with adhering to the budgets set by upper-level leaders than with the quality of the work. Assistant leaders found this especially frustrating, as a lack of focus on the latter would inevitably lead to economic challenges. Autonomy frustrations arose as Kelly felt a lack of support from HR in relation to facilitating the development and delivery of quality services within the budget and organizational structure. Kelly and other assistant leaders dealt with this by differentiating between operational and professional work. Not feeling comfortable in making decisions to ensure professional quality, Kelly let knowledge-workers take responsibility for such decisions. In this way, assistant leaders navigated and contributed to upholding the tensions and they simultaneously pushed responsibility for quality on staff, which as previously shown created more autonomy for staff, but also resulted in decision-making challenges. There was no indication of assistant leaders trying to deny or manage (control or eliminate) tensions, rather assistant leaders worked within tensions and thus they were kept in play.

Team leaders

The quote below from an interview with Sam highlights how autonomy of team leaders is also constrained by tensions between structural requirements and (lack of) formal power:

(Sighs) So it is limited. You are, in many ways, a toothed gear wheel in a knit stitch, right … those who stay as leaders, manage to find this little hatch where, here, I have autonomy. Er, everything else is system requirements that I must do. This I must do, there is no [possibility for autonomy], but just inside here (draws a square on the table), I can actually use myself and try to fill it with what I’m interested in and think is exciting, right.

Here, Sam mixes two metaphors, highlighting how Sam feels like a small, schematized, dependent element within a larger system. Illustrating this feeling, Sam draws a squared frame on the table in front of us—portraying a tiny room to maneuver some professional tasks and indicating that structural requirements are experienced as non-flexible, reducing the autonomy of team leaders to the minimum. For Sam, a tension exists between (boring) system requirements that must be complied with and professional work. Sam “finds a little hatch” of exciting work—an area which had been neglected for some time but which Sam managed to get on the agenda and is now a key person in developing, i.e. that Sam has the autonomy to organize. As such, Sam and other team leaders dealt with frustrations of the leader position by finding spaces where they could exercise autonomy to balance the spaces where they cannot.

Discussion: Upholding and creating constrained autonomy

Contrary to previous research suggesting that formal leaders sometimes deny tensions or are unaware of them (Collinson, 2014), or seek to control or eliminate them (Putnam et al., 2016), I argue that formal leaders are highly aware of autonomy tensions and construct them in complex, contradictory, and “knotted” ways (Sheep et al., 2017), so that tensions are upheld and left more ambiguous than they first appeared. Indeed, leadership seems to be a matter of keeping tensions in play rather than managing (i.e. denying, controlling, or eliminating) them, which further suggests a way to balance the two contradictory modes of organizing—leadership or autonomy (Alvesson et al., 2017) and accommodating the complex dynamics between “leaders” and “followers.”

Having discussed how multiple, simultaneously overlapping, and mutually reinforcing tensions between hierarchy/structural requirements, the limited ability to lead, and reduced formal leader power result in restrictions to enact leadership, make decisions, and prioritize work, I propose the notion of constrained autonomy as a way of conceptualizing these tensions. While the notion of constrained autonomy can be found in a few other studies, these are to my knowledge all conducted in fields with different foci, and the notion is only poorly defined. Honig (2019), for example, discusses politically constrained autonomy in international development organizations, and argues that constraints affect management’s control over field agents. However, the study does not focus on the organizational level, nor defines the notion. Lau and Wenzel (2015) also apply the term, but although their quantitative study discusses various parameters connected with autonomy, the meaning of constrained autonomy is not well discussed. The closest understanding of constrained autonomy to the present study is found in O’Carroll’s (2015) study on work time bargains. It suggests that people sometimes constrain their own autonomy in bargains and indicates that autonomy may be a rhetorical concept.

In summary, these studies introduce the notion of constrained autonomy and the idea that formal leaders despite and because of formal positions of authority may be constrained in different ways, yet the studies do not specify what they mean by the notion or provide thorough insights into the struggles of formal leaders and the complex, knotted ways in which they approach autonomy–authority tensions. Based on the analysis above, I therefore suggest that the notion of constrained autonomy may be used to highlight how formal leaders create and uphold tensions by “working within and around,” “creating more room,” and “providing more autonomy to staff” to deal with autonomy–authority related tensions, their in-between positions, and expectations around leadership in knowledge-dominated organizations. It may be helpful to imagine tensions as stemming from overlapping dynamics as illustrated in Figure 1.

Figure 1.

Tensions between themes.

Taking the starting point in tensions between autonomy–authority and autonomy–leadership as contradicting modes of organizing (Alvesson et al., 2017), Figure 1 illustrates how formal leaders may create and uphold tensions stemming from overlapping dynamics between structure, leadership, and power. In various interrelated ways, formal leaders split or compartmentalized autonomy-related tensions, which made it possible to maneuver between different responses to these tensions such as “working within and around,” “creating more room,” and “providing more autonomy to staff.” It seems that the hard lines theoretically drawn between autonomy–authority and autonomy–leadership were in practice dealt with in much more dynamic ways—involving the creation and upholding of tensions between structure, leadership, and power.

Working within and around: Being loyal, constraining own autonomy

Top-level leaders, department leaders, and assistant leaders described how they dealt with tensions by “working within and around” hierarchy and structural requirements to exercise some form of leadership and power. Top-level and department leaders dealt with constraining elements by “working within and around” requirements and expectations. By imposing constraints on themselves, they appeared responsive to staff, without risking their loyalty to upper-level leaders.

Assistant leaders dealt with autonomy–authority tensions by discussing decisions with staff, highlighting that knowledge-workers needed to be accountable for work quality and that assistant leaders could only be held responsible for operational tasks. Thus, they also constrained their own area for influence and autonomy.

Working within autonomy–authority tensions by constraining own autonomy and dividing work did not eliminate, remove, or solve tensions between structural requirements, formal power, and leadership actions. It involved the acceptance of working within contradicting expectations from above and below to tolerate tensions in autonomy–authority between leader levels and between leaders and knowledge-workers. Paradox literature has explained these interwoven, knotted contradictions as relational dialectic tensions that keep incommensurate positions in play (Putnam et al., 2016; Sheep et al., 2017). As such, working within tensions facilitated leaders keeping tensions in play, rather than denying, controlling, or eliminating them (Collinson, 2014).

Creating room: Being strategic, sidestepping the line, choosing your fights

In addition, department, assistant, and team leaders, contrary to the approach described above, dealt with autonomy–authority tensions by “creating more room” for their own autonomy. This was accomplished when department leaders “chose their fights” and thus navigated between the goals, strategies, budgets, and expectations from above and the values, ethics, and morals of staff to “get things going.” This approach seemed to work as a way of moving processes, decisions, work, etc. in the direction department leaders wanted, sometimes without full authorization from upper-level leaders and sometimes without full acceptance from staff. A similar approach was described by assistant leaders when they “sidestepped” the line leadership principle, technically being disloyal but legitimizing this by creating more opportunities for the organization and acquiring funds. Team leaders created more room for own autonomy by “being strategic,” “going through rounds of discussion,” and “creating small hatches” of interesting professional work.

These examples show how leaders at different organizational levels responded to autonomy–authority and autonomy–leadership tensions in similar ways. Constructing other tensions, e.g. between creating order and allowing for chaos, between loyalty and disloyalty, between dictating and allowing for discussion, between leadership and professional work, formal leaders privileged differences and tensions to develop “new space” (Putnam et al., 2016: 127)—new forms of autonomy within constraints—navigating contradictory ideas and forms of organizing (Alvesson et al., 2017). This is different from tolerating tensions by “working within,” and leadership thus surfaced through using tensions to develop options. However, top-level leaders may not have been able to “create room” as they were the guarantors for line leadership and for implementation of the CEO’s decisions. This may indicate that “creating room” for autonomy is easier and more acceptable the less power and responsibility one assumes for deciding hierarchical requirements.

Providing more autonomy to staff

“Providing more autonomy to staff” was a tension response, or a result of other tension responses, enacted by formal leaders across all organizational levels. It always came at the expense of leaders’ own formal autonomy and authority. Thus, it involves a tension itself. For example, staff were provided more autonomy when top-level leaders and department leaders chose to constrain their own autonomy to be responsive to them. Simultaneously enforcing control through line leadership, they switched between use of formal power and loyalty in the upper hierarchy, and delegating power and allowing autonomy for staff. They created tolerable forms of temporarily constrained autonomy for themselves, becoming controlled controllers (Harding et al., 2014) and providers of autonomy.

Slightly differently, and perhaps using some of the autonomy provided to staff (including lower-level leaders), assistant leaders and team leaders dealt with autonomy–authority related tensions by sidestepping line leadership and choosing “not to watch them like a hawk.” Thus, they arguably minimized potential conflicts from below, but by giving voice to staff they also had to constrain their own professional knowledge and formal leader power. In this process, formal leaders embraced multiple tensions at various levels and the differing expectations from above and below, and used this as a basis for reframing “the dynamic interplay between opposites” (Putnam et al., 2016: 127) to form new tensions and meanings which allowed them to lead in a way they found suitable for the context, both despite and because of differing expectations and values.

Being in the middle, formal leaders thus took different approaches to deal with the practical and emotional discomfort of boundaries to their autonomy. While formal leaders often felt like “being the stoker in hell,” they found ways of tolerating and even using tensions as opportunities for autonomy to lead. As illustrated above, this approach results in and from the upholding of multiple tensions—leaving them more ambiguous than they first appeared. Following this, constrained autonomy provides a nuanced way of accommodating and influencing autonomy–authority and autonomy–leadership tensions—both in theory and in practice.

Conclusion: Constrained autonomy

Much literature on formal leader autonomy seems to build on the idea of a sharp division between autonomy and authority. While Alvesson et al. (2017) has developed a model suggesting that autonomy and leadership are different and often contradictory modes of organizing, this paper has explored how formal leaders at various organizational levels experience and respond to exercising their own autonomy and authority in their relationships with superiors and staff in a knowledge-dominated context. Based on interviews with formal leaders and through a thematic analysis of these, I have shown how autonomy tensions evolve around and between formal leader levels and result in struggles around loyalty and line leadership, challenges in making decisions, and frustrations around lack of ability to prioritize and develop ideas. Contrary to previous research suggesting that formal leaders sometimes deny struggles and tensions or are unaware of them (Collinson, 2014), or in other ways seek to control or eliminate them (Putnam et al., 2016), I have illustrated that formal leaders are highly aware of autonomy tensions and construct them in such complex, contradictory, and “knotted” ways (Sheep et al., 2017) that tensions are rather upheld and left more ambiguous than they first appeared.

To conceptualize the intricacies around autonomy, I have proposed the notion of constrained autonomy. This notion has been used in a few other studies (e.g. Honig, 2019; Lau and Wenzel, 2015; O’Carroll, 2015) without specific definitions or a common and comprehensive expression of the complexities and challenges that formal leaders may experience around autonomy–authority tensions. The present study develops the notion and adds to this literature by highlighting how formal leaders at various organizational levels work within tensions—finding a balance between work where they can exercise autonomy and work where they cannot—sometimes creating new possibilities for autonomy for themselves and sometimes providing more autonomy to staff. While accepting constrained autonomy helped formal leaders tolerate autonomy–authority tensions, even using them as opportunities for creating new forms for autonomy, tensions were simultaneously upheld. Following, and complementing the model of autonomy–leadership (Alvesson et al., 2017), constrained autonomy seemed to be a way of conducting leadership in knowledge-dominated organizations characterized by complex power relations between “leaders” and “followers” (Collinson, 2014; Stohl and Cheney, 2001; Tourish, 2014). The notion of constrained autonomy thereby provides leaders with a practical way to enhance reflexivity around their leadership, power, and responses to tensions (Putnam et al., 2016; Sheep et al., 2017).

The study is narrow in its scope in studying the autonomy struggles of a relatively small number of formal leaders of one Norwegian organization. However, as universals have been found in particulars (Kempster et al., 2019), providing deeper insight into an additional layer of organizational tensions that people in various mid-level positions are likely to experience, the paper is suggestive of the challenges other formal leaders may face when seeking to lead in knowledge-dominated organizations. On a similar note, being willing recruits or reluctant formal leaders may have made a difference to the experiences of autonomy and how participants dealt with tensions. Future studies could explore this question and include analysis of professional identity tensions, status, or gender-related issues, which are also likely to be part of the autonomy–authority matrix.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Anne Kamilla Lund

Author biography

Anne Kamilla Lund is a researcher in the Department of Social Science, Organization and Leadership at Nord University, Norway. Her research interests center on leadership, autonomy, authority, power, and legitimacy.

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