Table 2:

The enactment of professionalism across the three cases, and its legitimacy and motivational power for clinicians.

	Seduction Appeals to professionalism as a desirable ideal; displays of inspiring leadership; provision of information	Deliberation Creating forums for clinicians to discuss among themselves the changes proposed and how they might be realized	Coercion Use of collective-level influence within the collegium to dictate proper practice, e.g. by publishing internal league tables	Enforcement Intentional alignment with other institutional logics to prompt change, e.g. government targets and incentive regimes	Consequences for motivating clinicians
ILCOP	Across all three cases: Grounding of proposed changes in appeals to professional values, and with reference to the evidence base; provision of information on current performance nationally and of participating team (in confidence); displays of professional leadership; highlighting of the risks of failing to change	Reciprocal peer review meetings between participating teams; national meetings for leads to report progress and learn from others	Presentation of data comparing outcomes, standards of data entry and process data across participating teams	Few alignment opportunities; letters to senior executives in participating teams’ host organizations to demand action; improvements could align with NCAT peer review	Appeals had legitimacy for clinicians in general, but acted as a motivating force only if they aligned with other logics (e.g. cancer targets). Resource demands achieved more legitimacy with administrators if also identified by NCAT reviews More influence achieved with core groups (e.g. respiratory physicians) than peripheral groups (e.g. pathologists)
AAA-QIP		Regional forums for all clinical groups to discuss changes and how they might be implemented locally	Presentation of data comparing outcomes, standards of data entry and process data across participating teams	Rationalization of service provision among hospitals and introduction of screening program drive introduction of changes similar to those advocated by AAA-QIP	Apparent synergy between state and professional logics, with both demanding very similar improvements—but where managerial requirements already met, motivation among clinicians and administrators harder to achieve More influence achieved with core groups ( vascular surgeons) than peripheral groups (e.g. anesthetists)
ENABLE		Training sessions for staff in each team, which offered a space for discussion of how changes might be implemented locally	Conference calls involving more than one participating team to compare progress	Alignment with state-mandated QOF incentives around CKD management for one of the intended changes	Motivation more evident where alignment with state logic achieved (i.e. in relation to existing incentive structures)Professionalism has limited legitimacy in itself, since generalist orientation of GPs militates against interest in a clinical issue facing only a small minority of their patients, and whose medical significance is questioned by some