Received: 18 September 2017 Revised: 24 May 2018 Accepted: 5 September 2018 DOI: 10.1111/faam.12195 ORIGINAL ARTICLE Clinicians and accounting: A systematic review and research directions Chiara Oppi 1 Cristina Campanale 1 Lino Cinquini 1 Emidia Vagnoni 2 1 Institute of Management, Sant’ Anna School of Advanced Studies, Pisa, Italy 2 Department of Economics and Management, University of Ferrara, Ferrara, Italy Correspondence Chiara Oppi, Institute of Management, Sant’ Anna School of Advanced Studies, Piazza Martiri della Libertà 24, 56127 Pisa, Italy. Email: chiara.oppi@santannapisa.it Abstract This paper provides a review of the literature concerning clinicians’ approach to accounting information systems (AISs) in healthcare organizations. The paper examines highly rated accounting and man- agement literature since 1980. Articles are categorized according to their research topics, settings, and methodologies, then findings are analyzed. Results show that clinicians’ resistance to accounting is the con- sequence of the inadequacy of AISs, which are designed according to reforms inspired by a managerial orientation. This suggests that future research should focus on AISs design, investigating patterns of implementation of AISs that can increase clinicians’ commitment to and use of accounting for decision making. KEYWORDS accounting information system, clinician, controller, healthcare, sys- tematic literature review 1 INTRODUCTION Since the 1980s, healthcare organizations (HCOs) worldwide have been subject to a series of managerial reforms, which emphasized economic results, disseminated a market culture and private sector practices (Hood, 1995), and proposed a managerial approach centered on planning and budgeting (Adinolfi, 2014). Reforms aimed to reduce costs and improve efficiency (Hill, 2000). Those reforms were undertaken in a context in which HCOs experienced economic concerns related to the increasing costs of their health services (France, Taroni, & Donatini, 2005; Negrini, Kettle, Sheppard, Mills, & Edbrooke, 2004). As a consequence of the reform process, HCOs started to introduce accounting techniques to control expenditures and to maximize both service quality and efficiency (Adinolfi, 2014; Hellström & Hallberg, 2001; Marcon & Panozzo, 1998). In order to cope with this changing environment and to address reforms, HCOs changed the way in which account- ing information systems (AISs) were shaped; the new AISs were designed to provide information directed at cost reduction and at supporting benchmarking (Guven Uslu & Conrad, 2008; Järvinen, 2009; Lehtonen, 2007). Clinicians have a significant impact on costs (Abernethy & Stoelwinder, 1995). Therefore, hospitals committed clinicians to a Financial Acc & Man. 2019;1–23. wileyonlinelibrary.com/journal/faam c  2019 John Wiley & Sons Ltd 1