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The old one-tier system of hospital governance in France has been replaced by a two-tier system, with physicians represented on both. Because one tier of the system has responsibility for the development of strategy and the other has responsibility for approving and monitoring it, it
is essential that the two sections work co-operatively and constructively together. This paper presents observations of the ways in which physicians deliver their roles on each board, and analyses these findings using relevant research on board dynamics and the theoretical perspectives of
social identity and integration. This led to the development of nine key propositions, which provide a synthesis of how physicians are currently performing in their governance roles in each tier.