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Results for “Gatekeeping”

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PubMed1987

School counselors as gatekeepers: guidance in poor versus affluent neighborhoods.

Previous studies reveal that career guidance is usually based on a mixture of meritocratic criteria (academic ability and achievement) and nonmeritocratic considerations (students' SES and their social labeling by counselors). The present study argues that school counselors in affluent neighborhoods emphasize the meritocratic criteria, while those in poorer neighborhoods tend to focus on the more nonmeritocratic. This hypothesis is examined in a random sample of 210 male, primary school graduates from the 10 state schools of an Israeli town, 125 of whom are from schools in affluent neighborhoods, and 85 from schools in poorer neighborhoods. A path analysis of determinants of guidance to specific high school tracks shows that students' ethnicity and labeling as problematic directly affect guidance by counselors only in the poor neighborhoods. The effect of students' "problems" is due to their being labeled as problematic with respect to psychological or physical attributes rather than to behavioral problems at school. The findings are subsequently interpreted as reflecting a patronizing attitude toward lower status students by counselors. Additional studies which may further elaborate the determinants of guidance in poor versus affluent neighborhoods are proposed.

Achievement↗
PubMed1986

Gatekeeper.

Explore the source record for details and available documents.

Humans↗
PubMed1987

Gatekeeping in primary care: a comparison of internal medicine and family practice.

Five hundred twenty new patients were randomly and prospectively assigned to receive their care in the Internal Medicine Clinic or Family Practice Clinic of a large university hospital. The patients were followed by residents in training under the supervision of board-certified internists or family physicians. After a mean length of care of slightly over two years, the charts were reviewed for frequency of visits to primary care providers (internal medicine or family practice), Emergency Room, Acute Care Clinic, and all clinics other than the two primary care clinics. The records were also reviewed for laboratory tests ordered. Frequency of visits to the clinic of primary care, Emergency Room, Acute Care Clinic, and broken appointments were all significantly higher for patients randomized to the Internal Medicine Clinic. In addition, the median total annual cost of laboratory tests for patients followed by internal medicine physicians was significantly higher, largely because of higher laboratory charges generated by the specialist consultants. Over the study period, internal medicine patients had a significantly higher number of visits to all nonprimary care clinics and specifically to the dermatology, obstetrics and gynecology, and general surgery consultant clinics. It can be concluded that in this clinical environment, the practice styles of internal medicine and family practice are different.

Adult↗