Doctor of Philosophy (PhD)


Human Resource Education and Workforce Development

Document Type



The purpose of this study was to describe the perceived emotional effects of the seven Medical Case Managers who moved from the role of “consultants” of a Railway to “employees” of a Managed Health Care Company in order to maintain employment within their field of telephonic disability case management of railway employees. This research followed the path of an unintended change with two interviews, 2003 and 2010. The participants were seven Medical Case Managers with a combined institutional knowledge base of over fifty years. The study was a qualitative study based on in-depth interviews. Results showed that the Medical Case Managers viewed the change from “consultant” to “employee” as an involuntary change or unintended change. The perceived emotional effects were issues of anxiety, stress, fear, betrayal, mistrust and distrust aimed at the Railway. As the change progressed, the perceived emotional effects became focused on the Managed Health Care Company with those emotions noted as mistrust, distrust, frustration, and ambivalence. These feelings led to what was in essence were a time of transitional turmoil and chaos. The Medical Case Managers did not feel that they had moved past the turmoil until they separated employment with the Managed Health Care Company and individually made a new career choice. The results also highlighted several interesting aspects. The Railway missed an opportunity for a smooth transition as did the Managed Health Care Company as they failed to acknowledge the stress and turmoil of the change. Either not being aware of the existence of emotional effects that surround change or ignoring them had far reaching consequences, the very least being the loss of over fifty years of institutional knowledge. This research has suggested that organizations need to be aware of change and the emotional effects that surround the process. By doing so, there exists an opportunity for well thought out process to aid in the practice of unintended change. Researchers, also, have an opportunity to expand theory by taking a look at significant career experiences, focusing on multidisciplinary emotional components as they impact both the individual and the organizational aspects of the workplace.



Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

Machtmes, Krisanna