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PubMed2005

The feminization of the physician assistant profession.

Although the physician assistant profession has historically been male-dominated, women now comprise over sixty percent of physician assistants (PAs) in the U.S. This paper explores the reason for the increase of women into the physician assistant profession in recent decades and whether gender differences exist in how PAs are utilized. Twenty-one qualitative interviews with male and female physician assistants and key informants were conducted to assess the reasons for the influx of women. In addition, data from the American Academy of Physician Assistants Census Survey (n = 16, 569) were analyzed to assess current gender differences in employment characteristics of PAs. In the interviews, female PAs reported entering the profession because it allowed them to practice within the medical model without having the high expense and demanding schedule of medical school. In fact, they claimed that the profession was quite compatible with family life. Significant gender differences were found in work characteristics, primary employer type, and practice specialty. Although women tend to concentrate in practice areas of women and children's health, evidence suggests that they are moving beyond these traditional roles into areas such as internal medicine and surgery.

Adult↗

PubMed2002

Health care chaplaincy as a research-informed profession: how we get there.

Health care chaplaincy should become a research-informed profession in the next ten years. This article describes my rationale for this statement and outlines a plan for accomplishing it. This means that all professional health care chaplains will value the contributions that research can make to their ministry and some chaplains will be engaged in research that informs the profession. Becoming a research-informed profession does not mean losing our emphasis on compassion, faith, presence, self-awareness, or any of the other rich resources of our tradition. It does mean supplementing those resources with the information research provides. I conclude that the question that professional health care chaplains face is not whether to become a research-informed profession, but how to get there.

Chaplaincy Service, Hospital↗

PubMed2004

Quality control of the private veterinary profession in The Netherlands.

It was as early as the 19th Century when attempts were first made to organise the veterinary profession in The Netherlands into a professional association. Since then, the Royal Veterinary Association of The Netherlands has developed into an organisation which fully promotes the interests of the profession. From the beginning, the issues of professional standards and veterinary legislation were given high priority, and codes of conduct were established with the aim of improving the quality of professional veterinary practice. Having some form of independent regulatory body has always been important for maintaining these professional standards, even if history has taught us that establishing such independent testing and sanctioning facilities is a laborious process that requires perseverance and patience. By organising the control of animal diseases and promoting public health (e.g. meat inspection), the veterinary profession has always had a key role to play in the food production industry, and quality control programmes that monitor the food production chain now make use of veterinary surgeons tested by external organisations. To avoid any semblance of a conflict of interest, a new organisational structure has been developed recently: the Veterinary Quality Organisation (VKO: Veterinair Kwaliteits Orgaan). The VKO maintains the register of qualified veterinarians, upholds standards and organises the independent quality control of the profession.

Animal Welfare↗

PubMed1996

For "the honor and dignity of the profession": organized medicine in colonial New Brunswick, 1793-1860.

This article discusses the several attempts to organize and regulate the medical profession in New Brunswick, Canada, between 1793 and 1860. It examines medical legislation during the colonial era, culminating in the creation of the Medical Faculty of New Brunswick in 1859. Also, it explores the desire within the profession itself for increased protection and recognition. This desire inspired the formation of several medical societies in the years following 1827. A central figure in professional organization was Robert Bayard (1788-1868), who graduated from Edinburgh in 1809. The article examines his relationship with his colleagues, notably Thomas Paddock, John Boyd, and Alexander Boyle, to identify personal tensions affecting the development of the medical profession. The article concludes that the medical profession acquired a significant degree of authority in New Brunswick only following the enlistment of legislative support. The search for greater authority stemmed from the advent of sectarian doctors in the province. Although sectarian practitioners never flourished in New Brunswick, the law of 1859 gave the province's regular doctors a sense of identitiy that facilitated the establishment of medical societies and the province's first general public hospital, in Saint John.

Canada↗

PubMed1991

Job involvement and job satisfaction of South African nurses compared with other professions.

The study was designed primarily to compare the work outcomes of job satisfaction and job involvement of South African nurses with those of members of 13 other professional groups in South Africa and with American nurses where data was available. Secondary aims included identifying areas where job satisfaction was particularly low and demonstrating the relative independence of the job involvement and job satisfaction constructs. A questionnaire incorporating the Kanungo Job Involvement Scale and the Short Form of the Minnesota Job Satisfaction Questionnaire was mailed to random samples of people between the ages of 29 and 41 drawn from 14 professional registers. There were 114 nurses in the final sample and 1677 members of other professions. Differences among professions were tested for significance using one-way analyses of variance and Bonferroni ranges tests. South African Nurses were shown to have extremely low job satisfaction relative to American nurses and to other professional groups in South-Africa. By contrast their job involvement was moderately high. The implications of these findings for the medical profession as a whole and for nurses in particular are discussed. The fear is expressed that wide spread dissatisfaction may lead to fewer people entering the profession and highly trained people leaving.

Adult↗

PubMed1992

Reasons for choosing occupational therapy as a profession: implications for recruitment.

This study examines the ways in which 272 recently certified occupational therapists learned of the profession of occupational therapy and the factors that influenced their decisions to choose occupational therapy as a career. The data were analyzed according to age, sex, and geographic region to identify potential ways to improve recruitment efforts. The results indicated that therapists most often learned of the profession while working in a health care setting. First exposure to occupational therapy was usually through an acquaintance in the profession, a family member, or a friend. The primary reasons for choosing occupational therapy included a desire to help people with disabilities, the promise of challenge and variety, the opportunity to work in a health care setting, and the belief that jobs are plentiful. The factors most likely to dissuade people from the profession were the expense of an education and lack of a clear understanding of occupational therapy.

Adult↗

PubMed2001

Registered male: a discussion on men in the nursing profession.

The aim of this discussion paper is to alert the profession to issues surrounding men in nursing. There is a historical connection between men and the nursing profession; men having served as nurses long before Florence Nightingale. Literature suggests that women and men enter the nursing profession for the same reasons, however the paths which lead men to nursing differ. Feminist sociologists express alarm at the disproportionate number of males in managerial nursing positions and hold that this may have negative consequences for the profession. Male and female patients have a definite preference in regards to the gender of their nurse. Issues surrounding this preference will be explored.

Australia↗

PubMed1992

Medicine and the health professions: issues of dominance, autonomy and authority.

Medical dominance of health care has traditionally been the organising principle in health care delivery. Medical power is manifested through the professional autonomy of doctors, through their pivotal role in the economics of health services, through dominance over allied health occupational groups, through administrative influence, and through the collective influence of medical associations. Using Friedson's four factor definition of medical dominance, a structured interview schedule was developed to examine one aspect of medical dominance, that is, doctors' control over the allied health professions. Ninety interviews were carried out with a sample of nurses, physiotherapists, occupational therapists, speech pathologists and psychologists working in various health care settings in metropolitan Sydney, seeking their perceptions on the way in which the medical profession interacts with their occupational group. The findings indicate that a significant proportion (73%) of health professionals did not feel regarded as professional equals by doctors. Nor did they feel that doctors had an adequate knowledge and understanding of their professions (73%). However, the majority (74%) felt that they had sufficient autonomy and were able to discuss doctors' instructions and offer advice or suggestions to doctors. Length of service significantly contributed to perceptions of professional autonomy amongst allied health professionals. These results support the view that the increased autonomy of the allied health professions has not impinged on medical dominance in the health care delivery system. Recommendations for further research and the training of medical and allied health professionals are made.

Allied Health Personnel↗

PubMed1989

The future of the PA profession. Panel discussion.

Growth and opportunity are the catchwords for the PA profession into the 1990s. Numerous changes can be expected, along with stimulating new challenges. Concern about the survival of the profession has waned. Current focus is on expansion of the profession to meet demands of America's changing health care delivery system. A distinguished panel of PA leaders discusses such issues as diversity within the profession, growth of hospital-based PAs, HMOs, public policy, PA education, the growing job market, and expanding roles of PAs.

Education, Graduate↗

PubMedDate not supplied

What nurses profess: the Elizabeth Bouvia case.

The prospect of nurses' cooperation in a patient's suicide raises the question, What do nurses profess? Confronted with the case of Elizabeth Bouvia, who in 1983 entered a California hospital intending to starve to death, a "nurse technician" would simply follow the physician-prescribed course of treatment, professing only a machinelike proficiency. A "nurse therapist," however, would work to become the patient's advocate, not judging but empathizing with the patient. Although supporters of Ms. Bouvia's position might appeal to this country's tradition of individual liberty and autonomy, the freedom of others also must be considered. As a community of professionals, nurses are bound by a set of ethics--beliefs that would be violated if they were forced to comply with her plan. And, as members of the civic community, nurses are responsible for protecting lives and fostering health and general welfare. A ruling in Ms. Bouvia's favor would have opened the doors for society to renege on its commitment to the handicapped and the gravely ill. The Bouvia case challenges nurses and all of society to reflect on what they believe in. What they profess must be more than mere tolerance of each other, more than technical proficiency, and more than a therapeutic understanding of patient needs. They must profess the sacred good of life and health.

Adult↗

PubMed2000

Complementary/alternative medicine: comparing the view of medical students with students in other health care professions.

OBJECTIVE: We compared the opinions, knowledge, and attitudes of final-year medical, physiotherapy, occupational therapy, nursing, and pharmacy students about complementary/alternative medicine (CAM). METHODS: A cross-sectional study questionnaire (n = 442) was administered on site at the University of Western Ontario and the University of Toronto to fourth-year health professions students. Outcome measures were self-reported knowledge, attitude, and perceived usefulness of CAM therapies, the perceived importance of scientific inquiry for the acceptance of CAM, and educational exposure to the topic. RESULTS: Educational exposure to CAM was correlated with the perceived usefulness of CAM. Medical students reported the least amount of education about CAM and viewed CAM therapies as less useful than did their health professions student peers. Medical students and pharmacy students were more likely than the other health professions students to view traditional scientific forms of evidence as necessary before accepting CAM therapies. CONCLUSIONS: Perceptions differed among the different health professions student groups about the usefulness of CAM therapies and the kind of evidence needed before they should be incorporated into standard care. This may have important implications for multidisciplinary care.

Adult↗

PubMed1975

Health law in 1985--implications for the optometric profession.

In conclusion, I believe that you should seek to expand the scope of optometry into areas now regarded as exclusively medical practice, and devote less time and effort to protecting your rear from the encroachment of the opticians. I suggest this because it follows a seemingly natural process of expanding upward that one finds in other professions and occupations in the health field. Second, I have suggested that, to achieve an expanded scope of optometry, there may have to be some sacrifice of the concept of the independent, entrepreneurial practitioner in optometry. Even the medical profession is recognizing that the individual entrepreneurial physician is becoming less of a factor than he was before, and the future is not particularly bright for him further down the road. Third, to the extent you can influence the forum where the struggle over the expanded practice of optometry takes place, you may increase the likelihood that the expanded role will be recognized by law sooner. I have already alluded to the idea that costs of health services and funding mechanisms are intimately tied to the law related to optometric practice in the future. As you know from the legislative struggles in many states over inclusion of optometric services within state Medicaid programs, and freedom of choice legislation that required an insurer to pay any legally recognized practitioner who could provide the service, rather than physicians exclusively, the optometric profession is well aware how closely the success of a profession is linked to access to third party payment.(ABSTRACT TRUNCATED AT 250 WORDS)

Health Services Accessibility↗

PubMedDate not supplied

Recreating nursing practice for a new century. Recommendations and implications of the Pew Health Professions Commission's final report.

The erratic path of evolution of health care in the United States creates daunting threats as well as new opportunities for institutions, professionals, and the public. Perhaps no stakeholder has more to risk or gain than professional nursing. As the largest of all the health professions, nursing serves as the backbone for much of the care delivery system. Historically, nurses have been employed primarily in hospital settings. Toward the latter part of the 20th century, however, nurses assumed such expanded roles as independent practitioners, managers of care in large health plans, and providers of alternative and complementary health care services. These new roles point to how nursing may rapidly evolve as the health care system addresses continuing issues of cost, performance, access, and consumer satisfaction. While today's opportunities are great, threats remain to the traditional role of the nurse in the hospital setting, through regulatory constraints on nursing practice and the lack of clear purpose and direction within the broad professional nursing community. Following a decade of leadership and advocacy for health professions education, the Pew Health Professions Commission issued its fourth and final report in December 1998. In this report, the Commission assessed the challenges facing professionals in the 21st century and made general and profession-specific recommendations for action.

Delivery of Health Care↗

PubMed1992

The organized American medical profession's response to financial conflicts of interest: 1890-1992.

Recent issues of financial conflicts of interest for physicians are illuminated by the history of similar issues from 1890 to 1992 and the response of the organized medical profession to activities like payment of commissions, or "fee splitting," physical ownership of medical facilities, and dispensing of drugs. The medical profession tried to confront these and related conflicts early in the century, in some cases by adopting ethical codes, but was unable to enforce standards of conduct. Since the 1950s, substitutes for fee splitting emerged and were tolerated by the profession. Moreover, its stance became weaker as it abandoned its earlier clear ethical prohibitions and relied instead on subjective standards and, more recently, on disclosure to patients. The medical profession still favors voluntary codes of ethics, setting aspirational goals, promoting a patient-centered ethos, and relying on the good will of individual doctors--tactics for dealing with financial conflicts of interest that this review of recent history suggests are inadequate. Instead, public intervention is required to address these problems.

American Medical Association↗

PubMed2003

3000 by 2000 and beyond: next steps for promoting diversity in the health professions.

In 1991, the Association of American Medical Colleges (AAMC) launched a national campaign to enroll 3,000 underrepresented minority students in medical school by the year 2000. (The AAMC defined underrepresented minorities as blacks, Mexican Americans, mainland Puerto Ricans, and Native Americans, which includes American Indians, Alaska Natives, and Native Hawaiians.*) The initiative, named Project 3000 by 2000, focused on education-pipeline interventions. Although the project did not meet its numeric goal, in large part because of court decisions in several regions of the country that hampered affirmative action programs, Project 3000 by 2000 did have a number of important successes. At a time when there is a need to develop new and creative ways to promote diversity in health professions education, there are a number of lessons to be learned from this project. Large-scale national campaigns serve an extremely useful purpose in promoting diversity in the health professions. And for these campaigns to be successful, it is important that the health professions work together to coordinate their activities and share their resources to ensure that health professions close the diversity gap in the twenty-first century.

Cultural Diversity↗

PubMed2003

The occupation of healthcare management: relating core competencies to growth as a distinct profession.

There are many questions regarding the education of the healthcare manager. Some would argue that rather than focus on specific issues of core competencies and licensing, the discussion should be directed toward the successful development of healthcare management as a distinct profession. Two elements in defining a profession, education and legal restraints, are particularly relevant to healthcare management. It would be extremely difficult, if not impossible, for healthcare management to achieve recognition as a distinct profession in the traditional sense. There is no unique body of knowledge on which the profession is based, and no mechanism for credentialing to restrict practice. The organizational framework, however, does exist to better position the MHA-prepared graduate as the preferred candidate to manage healthcare organizations. A professional society needs to be identified as the representative society for the generalist healthcare manager. Core competencies should articulate the integration of academics and practice preparation. To accomplish the latter, academic accreditation requirements relating to faculty credentials should encourage practice-based credentials in addition to the current exclusive focus on academic credentials.

Credentialing↗

PubMed2004

Knowledge, attitudes and intention of high school students towards the nursing profession in Riyadh city, Saudi Arabia.

OBJECTIVE: To determine the knowledge, attitudes, and intention among the Saudi high school students towards the nursing profession. In addition, the study aims to identify students' perception of causes preventing them to become nurses. It also aims to determine the factors influencing the Saudi high school students' choice of nursing profession. METHODS: We used the descriptive analytical research design. Stratified random sampling procedures were employed to represent the Saudi high school students, 3 male and 3 female schools scattered in all areas of Riyadh city were selected. A total of 600 questionnaires were distributed and 503 questionnaires were returned, of which, 479 questionnaires were valid for analysis (79.8% response rate). The data collection started from November 2002 to January 2003. Descriptive and inferential statistics were used to analyze the collected data. RESULTS: High school students scored a reasonable level on the knowledge dimension, but did not achieve high scores on the attitude dimension, however, they achieved very low scores on the intention of being a nurse in the future (5.2% of them indicated nursing as their preferred future job). Inferential data analysis showed that attitude, having or not having a nurse friend and knowledge was found to have significant positive influence on high school students' intention, while long working hours and high work load compared to other jobs were found to have a significant negative influence. CONCLUSION: Results indicated that the more knowledge and positive attitude on nursing, the more likely the student would be attracted to the nursing profession. Accordingly, it could be concluded that Saudi health decision-makers need to increase the positive attitude on the nature and encouraging characteristics of modern nursing and its increasing respect as a skillful career for high school students. Reconsideration of salaries and benefits were recommended in order to attract more students to the nursing profession.

Adolescent↗

PubMed2004

Is dentistry a profession? Part 3. Future challenges.

In 2 earlier articles a definition of professionalism was developed, and several specific professional responsibilities were deduced. This third and final article in the series examines whether dentistry qualifies as a profession. On various levels, the professionalism of dentistry is found wanting. However, attaining the status of a profession is a work in progress, which means that each profession will always have some deficiencies. The author concludes that dentistry qualifies as a profession but that it is also exhibiting a trend toward once again becoming a business (as it was before the 19th century). For the sake of honesty with the public, dentistry must make a choice between these 2 models.

Clinical Competence↗