This qualitative field study examines how volunteering and managerialism shape the organizational identity of six patient organizations from six different European countries. Volunteers represent a large part of the workforce in most voluntary associations. Even though the phenomenon of volunteering is becoming more and more important for organizations and society alike, so far it has only been studied at the individual level. The authors draw on the theoretical concept of dual organizational identities to describe the two differing collective self-descriptions that were present in the patient organizations. Drawing on 34 narrative interviews and focus groups, the authors document the differing perceptions of volunteers and paid staff about their organization's identity and show how the conflicting dimensions-volunteer identity and managerial identity-result in intraorganizational conflict