Organizational imperatives--what motivates providers?
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Biomedical subjects
Publications and source records attributed to R Fink.
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An opportunity to examine the effects of significant, widely reported events on participation in a breast cancer screening program was presented when countrywide public attention was called to breast cancer by reports of the breast surgery of the wives of President and Vice President of United States. These events occurred in September and October 1974 while a breast cancer screening program was underway in the health Insurance Plan of Greater New York. The research design of this program permitted measurements to be made of the participation of the plan's members in the screening before, during, and after these famous mastectomies and of the participants' characteristics during different periods of the research program. In late 1974, when there was great mass media emphasis on breast cancer, participation rates in the breast cancer screening program increased significantly. In the study periods immediately following, however, participation rates declined to previous levels. The increase in Participation rates in late 1974 was fairly uniform among all demographic groups, whether classified by age, education, income, race, or religion. In addition to increases in the participation rate associated with the events of late 1974, there was also an increased tendency among women who were screened to respond readily to mailed invitations to appear for screenings. This increase insensitivity to efforts to win their participation was more pronounced among those groups that this study and other studies have shown are more likely to participate in preventive health programs and to respond more readily to request to participate.
A mail survey was conducted among 69 group practice health maintenance organizations (HMOs) to collect information on the recruiting of primary care physicians and specialists. In reporting on difficulties in recruiting physicians for primary care, the medical directors of HMOs indicated that the greatest problem was locating obstetrician-gynecologists. Among specialists, recruiting for orthopedists was reported as being most difficult, although plans that employ neurologists and anesthesiologists generally reported great difficulty in recruiting these specialists. The most important source of new physicians is the pool of the those completing residencies, describe by nearly three out of four plans as a very important resource. The next most important source was faculty or staff of medical schools or teaching hospitals. The recruiting methods reported by most plans as the most useful are direct personal contacts and advertisements in newspapers and journals. About one-fourth of the HMOs found unsolicited inquiries from physicians a useful method of recruiting. The problem most frequently reported in recruiting new physicians was that of matching fee-for-services incomes and second, but far less frequently mentioned, was physician prejudice against group practice. About one in four plans report that residents trained in their own HMOs were a useful recruiting source.
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