Other work uncovers the hybridization of nurse and physician managers who come to work both in the interests of the organization as well as their profession (Duran Arenas et al 1992, Hunter 1992) though this has been criticised in some contexts, particularly in the case of Managed Care in the U. S. (Leicht & Fennell 1997, 2001). [...] The specific purpose of this research was to analyse how the concept of „Social Words‟ was pertinent in the case of French hospitals, with a particular focus on the influence of the environment, division of labour, professional identities and organisational cultures. [...] The Secondary Data Analysis The secondary analysis of the data from these two studies began initially with a discussion of the similarities of our findings with respect to the pressures that organizations impose upon health care professionals and their responses to these pressures. [...] In the following example, a nurse in an outpatient clinic in a large urban hospital in California, negotiates directly with the patient to ensure that they get access to the care, circumventing the administrative denial of care in hospital by whispering to patient to check himself in through the ER: 3. All of the quotes from health care professionals in France have been translated into English. [...] Part of the cohesiveness of the group was related to interpersonal dynamics – not the least of which was related to the chief surgeon‟s position.