Why Become a Healthcare Manager? Ethically Reflecting on the Path to Leadership of Public and Private Sectors’ Occupational Therapists of Quebec-Canada

Pursuing management training within a health profession is motivated by multiple considerations varying according to individuals' values, personalities, and context. This article aims to describe the Quebec-Canada occupational therapists' motivations to become healthcare managers and their appreciation of the management (likes and dislikes/challenges), all analyzed from an ethical perspective. A descriptive phenomenologically inspired approach was used. Data were collected using sociodemographic questionnaires and semi-structured individual interviews. The verbatims were analyzed using Husserlian phenomenological reduction. Public- and private-sector managers' groups were compared with descriptive statistics. Results were discussed using the Quadripartite Ethical Framework (Drolet; Drolet & Hudon; and Drolet & Ruest). Twenty-seven occupational therapists-managers (n = 27) from public (n = 15) and private (n = 12) sectors were interviewed. Time as clinician before starting management and training aspects were different between sectors. Three main emerging motivations to become a manager are common to both sectors: personality-related factors, external factors, and desire to improve things. Dissatisfaction with work in the public sector emerged as a fourth motivation within the private sector. In public sector, the most cited motivation was to get involved in decision-making, while it was the desire to work according to one's ways within the private sector. For both sectors, the human dimension and the love of management were the higher appreciated aspects, whereas human resources management issues and heavy workload were the greater challenges. This study highlights duality between professional and managerial logics and the challenge of multiple loyalties. Management training does not necessarily make the work any easier. Occupational therapist managers have ideals, too often shattered by the organizational constraints encountered. Results can contribute to improve occupational therapist' training and leadership development and to better understand ethical issues surrounding healthcare management.