We examine how established elite professionals resist institutional change when the status quo of group-level corruption is threatened. Specifically, we explore how senior physicians resisted government reform intended to eliminate institutionalized corrupt practices within the state healthcare system in Peshawar, Pakistan. Drawing on 76 interviews with respondents from three state-run teaching hospitals, we discover how senior physicians routinely took advantage of their status and power to leverage gains from lucrative private practices. Further, we reveal how they attempted to sabotage government measures by engaging in three discrete forms of defensive institutional work: emotional work through tactical rhetoric, exercising self-fulfilling agendas through manipulation, and misuse of professional expertise as a bargaining tactic. Based on our findings, we present a theoretical model that delineates elite professionals’ use of defensive strategies to preserve corrupt systems that serve their self-interest. Our findings have implications for research on organizational corruption and institutional change.
