This paper studies doctors in Norway and Finland to compare how identities among professionals in managerial positions were expressed after changes in management in the aftermath of ‘New Public Management’ (NPM) reforms. Studying shifting identities provides a basis for investigating how institutions have changed and illuminates how agents within an organisation have implemented NPM-inspired reforms. Data from both countries revealed three groups: the majority of doctors/managers, who had a strong managerial identity; a smaller group who mainly identified as doctors; and a few doctors who displayed hybrid identities. Work experiences have a strong effect on how identity is perceived. Doctors who hold on to their professional identities seemed uneasy with their skills and ability to perform the tasks related to their new position. Many of the doctors were found to have altered their identities due to organisational amendments and the expanded focus on management-related issues. Hence, this paper concludes that a strong intervention in the sector from central government, as seen in Norway, has resulted in implementing general management to a larger degree than in Finland, but in a more hybrid manner. This is expressed through a focus on management, the institutional logics at stake and doctors’ identity formation.