The present study describes and analyses how social interactions between individual actors form institutionalwork in the highly institutionalized setting of healthcare organizations. Based on a qualitative case study, weaffirm that social interactions mainly form maintaining institutional work, thus primarily upholding the rigidityof healthcare organizations. Social interactions either preserve distance between different actors or prevent theirmutual influence, which decreases the effects of institutional complexity. However, when institutional work goesbeyond maintaining, social interaction is characterized by processes of claiming influence and granting influencebetween individual actors who adhere to different institutional logics, which allows effects of institutionalcomplexity. Such institutional work is contingent upon physicians’ strong power position, and granting influenceis likely to precede claiming influence.