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PubMed2006

Assessment of alcohol and other drug use behaviors in health professions students.

Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by surveying both university-based HPS and other nursing programs in a Midwestern state in 1999. Response was 2,646 (56.4%) of surveyed students. Family history of alcohol-related and drug-related problems were reported by 39.8% and 13.9%, respectively, with 42.6% of respondents reporting one or both. Among nursing respondents, 48.1%, 19.2% and 51.1%, respectively, reported family problems with alcohol, drugs, or one or both. Past-year alcohol use was comparable to undergraduate college students (UCS) nationally (83%); heavy drinking, tobacco and recreational drug use by HPS were lower. Past year drug use was highest among medical students. Marijuana was the predominant illicit drug; medical students and males most often reported use. Health professions educational systems should proactively address student AOD prevention, education and assistance needs.

Adult↗
PubMed1995

Toward a virtue-based normative ethics for the health professions.

Virtue is the most perdurable concept in the history of ethics, which is understandable given the ineradicability of the moral agent in the events of the moral life. Historically, virtue enjoyed normative force as long as the philosophical anthropology and the metaphysics of the good that grounded virtue were viable. That grounding has eroded in both general and medical ethics. If virtue is to be restored to a normative status, its philosophical underpinnings must be reconstructed. Such reconstruction seems unlikely in general ethics, where the possibility of agreement on the good for humans is remote. However, it is a realistic possibility in the professional ethics fo the health professions where agreement on the telos of the healing relationship is more likely to arise. Nevertheless, virtue-based ethics must be related conceptually and normatively to other ethical theories in a comprehensive moral philosophy of the health professions. If he really does think there is no distinction between virtue and vice, why, sir, when he leaves our house, let us count our spoons. Samuel Johnson

Ethical Theory↗
PubMed1997

Money and the medical profession.

Money motivates people, lubricates the movement of resources, mobilizes talent, and breaks down some barriers. But money also has a darker side; it can distract, corrupt, distort, and cruelly exclude. Money is a useful but unruly servant; sometimes, a hard master. The professional, at least in part, belongs to the world of money. We sometimes distinguish the amateur from the professional in that the amateur does it for love; the professional, for money. The professional has one foot in the marketplace, but also, purportedly, professes something else -- beyond the bottom line. The following discussion explores the morally complex ties and tensions between money and the medical professions.

Conflict of Interest↗
PubMed1979

Self-regulation in the dental profession.

Structured and open-ended questions were posed in a survey of dentists in solo and nonsolo practices to test assumptions concerning clinical norms and the self-regulatory aspect of the health professions. The importance of autonomy in their perceptions of practice influenced the dentists' responses to several developments; among them are peer review and third party programs that affect the profession.

Adult↗
PubMed2000

The Surgeon General's report on America's oral health: opportunities for the dental profession.

BACKGROUND AND OVERVIEW: The release this year of "Oral Health in America: A Report of the Surgeon General"--the first such report on this topic in U.S. history--gives national visibility to the scope and breadth of oral health and disease in America. The report emphasizes oral health's inextricable link to general health and well-being. Although the country has seen major improvements in oral health, some population groups have yet to benefit from these improvements. To address health disparities and improve quality of life for all Americans, the surgeon general's report calls for the development of a National Oral Health Plan. CONCLUSIONS: "Oral Health in America" identifies opportunities for the dental profession on behalf of the nation's overall health. The profession is uniquely positioned to ensure that all components of the National Oral Health Plan are addressed: changing perceptions to ensure that oral health is seen as integral to general health; removing barriers to care; enhancing health infrastructure; accelerating the transfer of science into practice; and continuing to participate in private/public partnerships. CLINICAL IMPLICATIONS: The report's findings highlight the importance of assessing patients' known risks of experiencing oral diseases and of educating patients about health-promoting behaviors. The integral role of oral health in general health, as described in the report, makes it imperative for health professionals to ensure appropriate referrals to practitioners in all areas of health care.

Dental Caries↗
PubMed2005

[Nursing: the meaning of this profession to nurses. A first approach].

In an attempt to understand, tell and, why not, participate a little in the history of Nursing, we proposed to study the prejudices and negative stereotypes that have permeated this profession over time. This is a before-after experimental type of study in a population of adolescents regularly enrolled in the eleventh grade of a Brazilian public school. The intervention took the form of a lecture about the profession and a questionnaire with closed questions which was applied before and after the lecture. Conclusions were based on the results of binomial and McNemar's non-parametric tests for the significance of changes. Although the statistically significant presence of prejudice and negatives stereotypes was not found, the results of the intervention were in line with expectations, since the changes(or tendency towards changes) took place exactly in those subgroups that showed a greater frequency of stereotypes.

Adolescent↗
PubMed2006

Addressing health care disparities and increasing workforce diversity: the next step for the dental, medical, and public health professions.

The racial/ethnic composition of our nation is projected to change drastically in the coming decades. It is therefore important that the health professions improve their efforts to provide culturally competent care to all patients. We reviewed literature concerning health care disparities and workforce diversity issues--particularly within the oral health field--and provide a synthesis of recommendations to address these issues. This review is highly relevant to both the medical and public health professions, because they are facing similar disparity and workforce issues. In addition, the recent establishment of relationships between oral health and certain systemic health conditions will elevate oral health promotion and disease prevention as important points of intervention in the quest to improve our nation's public health.

Cooperative Behavior↗
PubMed1992

Freidson then and now: an "internalist" critique of Freidson's past and present views of the medical profession.

Freidson is a foremost analyst of the medical profession. Most recently Freidson attacks those who claim that medicine is declining in power. He insists that medicine has not lost the core elements that make it a powerful, indeed, the dominant, health profession. The author compares Freidson's early writings on medicine with his most recent ones, and shows that there are critical confusions in Freidson's central concepts of professional autonomy and dominance. This difficulty is illuminated by viewing dominance, autonomy, and subordination as on a continuum of control. Using this continuum, the author argues that Freidson implicitly admits what he set out to deny (that medicine has not declined in power) by shifting his focus from medical dominance to that of autonomy. Freidson also now rejects valid parts of his earlier work (that which emphasizes social structural determinants of behavior over socialization). In equating medicine in the United States with teaching in that country, Freidson's contention of "little change in medical power" meets its own refutation. Finally, despite his derogation of others, Freidson's lack of an adequate framework to explain the dynamics and not simply the structure of health care produces purely normative, utopian (and unhelpful) policy recommendations.

Communism↗
PubMed1989

Proletarianization or restratification of the medical profession? The case of obstetrics.

Professional dominance, autonomy, and control have been consistently emphasized in theories of the medical profession. Recently, however, the professional hegemony that physicians have enjoyed is increasingly being questioned in the light of profound changes that are taking place in the organization of health care in the United States. Debates about the implications of the power of medicine and the means by which it is maintained are being replaced by attempts to understand professional decline. Proletarianization (McKinlay and colleagues) and restratification theory (Freidson) are two prominent and competing predictions for the future of the medical profession. Taking obstetrics as a critical case, this article considers the relative ability of these theories to elucidate the changing organization of maternity care in one state and presents a case study of patient care in one hospital. It suggests a disjuncture between obstetricians' inability to protect their interests as a corporate body and their relative ability to control the organization of everyday medical work. It is concluded that more theoretical clarity is needed on professional behaviors at the macro and micro levels.

Ambulatory Care Facilities↗
PubMed1980

He who pays the piper: foundations, the medical profession, and medical education reform.

The development of modern medical education was shaped by the medical profession's own reform strategies and by material and ideological support from the corporate class. This article examines how the Rockefeller medical philanthropies, the largest single source of funds for medical education reform from 1910 through the 1930s, forced the adoption of a specific reform--full-time clinical faculty--to make medicine serve the needs of capitalist society rather than the interests of the medical profession. Memorandums and letters from archival files demonstrate that foundation leaders believed the full-time plan would separate medical schools from the grip of practitioner-dominated medical societies, bringing all medical faculty under the control of foundations and university boards of trustees. This policy was to be a first step in rationalizing medical care and distributing the technical benefits and social-control functions of medicine to all segments of the population. The author traces the development of the full-time plan, its adoption as foundation policy, and the struggle over its implementation.

Academic Medical Centers↗
PubMed1976

Regulation and control of the medical profession in Great Britain.

Regulation and control of the medical profession are evaluated in the light of recent inquiry into the British General Medical Council. The Report of the Committee of Inquiry into Regulation of the Medical Profession is examined and its worldwide applications are discussed.

Social Control, Formal↗
PubMed1992

Faculty development in the health professions: conclusions and recommendations.

This report summarizes recent literature reviews and resource books on faculty development in the health professions and describes findings from articles not previously reviewed. Nine conclusions about faculty development in the health professions are drawn: (1) the concept of faculty development is evolving and expanding; (2) research skills are becoming a major focus of faculty development; (3) teaching skills are still a prominent aspect of faculty development; (4) fellowships are being used effectively to recruit and train new faculty; (5) the institutional environment has become a focus of faculty development; (6) faculty evaluation is an effective approach to faculty development; (7) the efficacy of faculty development needs better research documentation; (8) model curricula have been developed for different types of faculty; and (9) comprehensive faculty development centers are gaining in popularity. A set of recommendations based on the conclusions drawn is offered for those planning faculty development interventions.

Faculty, Medical↗
PubMed1992

How to evaluate educational programmes in the health professions.

This paper advocates an alternative approach to the evaluation of educational programmes in the health professions. In the past, effectiveness of programmes has been judged by casual observations, visitation reports by outside experts, student performance at nationwide examinations, systematic surveys and experimental research. Decisions have been made based on either one or more of the above methods. It is being argued that these methods are not always appropriate and mostly inadequate in providing a holistic description and judgement of the educational programme. Social science disciplines have contributed to the development of case study, an alternative methodology, for evaluating educational programmes. The case study design is emerging as a legitimate approach for evaluating educational programmes. Qualitative methods such as participant observation, interviewing and documentary analysis have been found to bring new insights in evaluating short-term and long-term programmes in medical and allied professions. Although qualitative methods are emphasized in case studies, quantitative data from survey instruments can increase the credibility and understanding of the evaluation results. Different measures have been suggested to deal with questions of validity and reliability in case study evaluation.

Health Education↗
PubMed1995

The Medical Profession in Upper Canada reconsidered: politics, medical reform, and law in a colonial Society.

This study explores some of the important questions raised but not answered in William Canniff's standard century-old study, The Medical Profession in Upper Canada, 1783-1850. Primarily based on the original medical licenses issued between 1819 and 1841, an array of manuscript material belonging to the Civil Secretary of Upper Canada and the Colonial Office, and documents pertaining to the Medical Board of Upper Canada, this article argues that the disallowance of legislation for the establishment of a colonial College of Physicians and Surgeons in 1839 can only be fully understood in the context of demographic, political, and medical developments which included factors such as ethnicity, tensions between the colony and mother country, and rivalry between medical schools. It explains why the issues of the 1830s continued into the 1840s and undermined any possibility by the profession of forming a single, self-regulating, and unified medical body for licensing and educating practitioners.

Canada↗
PubMed2003

National workshop on core competencies for success in the veterinary profession.

A workshop was designed to (1) present results of the Core Competencies for Veterinary Medicine project conducted by Personnel Decisions International (PDI); (2) discuss and analyze the implications of the PDI study results for academia, private practice, and industry; (3) identify actionable items-discuss opportunities and barriers; and (4) develop appropriate recommendations-devise specific actions for implementation as next steps. In total, 25 veterinary colleges were represented at the workshop and a total of 110 attendees participated, a broad cross-section of the veterinary profession (both academic and non-academic). Through an orchestrated combination of general sessions and facilitated, small group discussions, prioritized recommendations for implementation and initial action plans for next steps were developed. Recommendations included publicizing results of the PDI study, reconsidering current admissions policies and processes, evaluating the applicant pool and current recruitment programs, developing structured mentoring programs, enhancing DVM/VMD training programs, coordinating the development of continuing education programs, and overcoming existing barriers to change. Next steps should involve collaborative efforts across all sectors of the veterinary profession to develop plans for implementing the workshop's recommendations. Leadership for follow-up might reasonably come from the Association of American Veterinary Medical Colleges (AAVMC), the American Veterinary Medical Association (AVMA), and the American Animal Hospital Association (AAHA), either individually or collectively, through the National Commission on Veterinary Economic Issues (NCVEI). Partnerships with industry are also possible and should be strongly considered.

Animals↗
PubMed2004

Disability as difference and the nursing profession.

Disability viewed as human difference under the broad umbrella of cultural diversity provides new possibilities for nursing to unite and show what it believes and stands for as a profession. Core essentials of professional nurses are considered. As nurse educators challenge traditions that perpetuate barriers to valuing human differences, the profession, those accepted into it, and those served by it will benefit.

Cultural Diversity↗
PubMed2005

Kuwaiti high school students' perceptions of nursing as a profession: implications for nursing education and practice.

The shortage of nurses in Kuwait is attributed to low production of indigenous nurses, resignation and emigration of foreign nurses, and expansion of health care facilities. This study explored Kuwaiti high school students' perceptions of nursing as a profession, their sources of information about nursing, and factors that affected their choice of nursing as a future career. Questionnaires from 289 students attending seven all-female high schools in Kuwait were analyzed. The results revealed that all of the participants were knowledgeable about the functional aspects of the nursing profession, and 35% of them received this information through contact with nurses during hospital visits. However, only 19% indicated they might consider nursing as a future career. The implications of the study for nursing education and practice, and strategies to attract and retain indigenous high school graduates into nursing programs in Kuwait are discussed.

Adolescent↗
PubMed2004

[The change in medical practice. Psycho-social challenges for the profession].

This article analyzes important changes in medical practice, focusing in those most deeply perceived by a group of physiciansfrom the Metropolitan Region of Santiago, included in a joint research conducted by the Departments of Psychiatry and Mental Health (East) of the Medical Faculty at the University of Chile and Public Health of the Catholic University of Santiago, during 2003. These are the perceived changes in the relationship between doctors and patients; increased limits in professional autonomy and the fragmentation of medical practice. Reflecting transformations in social relationships in general, they have added new stress and frustrations, as well as new opportunities and rewards to the medical profession. The perceptions identified are commented within the structural determinants of medical practice. These issues call for a refreshing discussion on the values supporting medical professionalism and the concept of profession in itself, in view of the challenges posed by the current social and cultural changes.

Focus Groups↗