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Results for “Professional Autonomy”

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At least 865 records · Page 48Linked to original sources
PubMed1999

How will we regulate genetic enhancement?

Genetic enhancement technologies present difficult and novel regulatory issues, including the problem of measuring and comparing risks and benefits and dealing with the impact of these technologies on social values. This Article describes and evaluates the potential approaches that may be taken to regulate these technologies. The author concludes that a variety of approaches will be necessary, involving self-regulation, government restrictions on access and use, licensing, and a national lottery.

American Medical Association↗
PubMed2003

Regional accents. The RCN policy unit compares NHS plans across the UK.

All three NHS plans that form the modernization agenda can be characterised by three themes: Centralization Partnership Culture change. Despite the absence of a Northern Ireland plan, the issues and themes that emerge in the other three plans are prevalent in Northern Ireland too. CENTRALISATION: The tendency to centralize has led to a greater involvement of health ministers, rather than civil servants, in the day-to-day running of the health services, but ministers are preparing to hand over operational control of new policies. PARTNERSHIP: Partnership underpins many of the new structural arrangements, with an emphasis on increased inter-professional working and education, but merged health and social care structures create funding tensions. CULTURE CHANGE: Culture change focuses on creating patient-centred care and dismantling the power of the health professions, while the curbing of professional autonomy is central to enhancing and improving patients' overall experience of the NHS. The cumulative effect of these developments is likely to lead to increasing debate about the future funding, provision and accountability of the NHS as regional and country differences continue to develop.

Health Care Reform↗
PubMed2004

Professionalism.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1999

Governing police practice: limits of the new accountability.

The advent of public-sector managerialism has brought with it a new principle of police accountability in Western democracies such as Australia and Britain. The new accountability gives emphasis to managerial rather than legal or public-interest standards, favours external oversight combined with self-regulation rather than centralized control, and promotes risk management rather than rule enforcement. This article makes use of the experience of an Australian police force to show that the new accountability has not been successful in holding police accountable, while elements of the old accountability have re-emerged to dominate public debates. It is argued that in the area of police governance, the neo-liberal state does not necessarily pursue a coherent strategy of 'acting at a distance' (cf. Miller and Rose 1990), partly because of the inability of accountability technologies to deliver substantially the promised policy outcomes and partly because of the sensitivity of its political arm to the public's moral outrage against corruption (cf. Garland 1996).

Australia↗
PubMed2004

[Evidence-based medicine from the office-based physicians' point of view: a representative survey on its acceptance and demand for continuous medical education].

In 2002 a curriculum on evidence-based medicine (EbM) has been developed and published in Germany on behalf of the national statutory health care administrations. Planning and guiding medical education in EbM requires an empirically-based knowledge of the level of awareness and acceptance of EbM as well as specific educational needs and organisational preferences. In Germany, there is no such systematic knowledge, particularly in regard to general practitioners. A random sample of 900 office-based physicians in the German state of Schleswig-Holstein, stratified by medical specialties, was surveyed by means of a postal questionnaire. After two reminders the response rate was 65.6%. Respondents mainly welcomed EbM, in terms of their own daily work, for the benefit of the patient and the healthcare system as a whole. Integrating EbM into their daily practice and possible restrictions to therapeutic freedom were considered the most serious problems of EbM. 46.8% of the respondents were interested in EbM training. They preferred a rather low-cost 2-day weekend seminar. Office-based physicians were found to be sufficiently motivated to participate in EbM courses, which is in marked contrast to the actual participation rate being rather low in Schleswig-Holstein. The training should primarily focus on integrating EbM into daily routines. In public presentations efforts should be directed towards promoting the way in which EbM enhances professional autonomy and therapeutic freedom.

Curriculum↗
PubMed2004

The '2-week rule' for suspected breast carcinoma: a qualitative study of the views of patients and professionals.

BACKGROUND: The '2-week rule' for the referral of patients with potential cancers is an important but controversial development. AIMS: To investigate the 2-week rule for women with breast problems from the perspective of the patients and of healthcare professionals. DESIGN OF STUDY: Qualitative study using semi-structured interviews. SETTING: Patients referred to two breast care units and professionals from primary and secondary care in Teesside and Hartlepool. METHOD: Semi-structured interviews with a purposive sample of 12 patients referred under the 2-week rule and 20 professionals. RESULTS: All women experienced considerable worries in the time leading up to diagnosis. This affected relationships with others, and they used selective telling to help maintain control over their own anxiety and prevent anxiety in others. They were not aware of the 2-week rule as a new initiative, but wanted quick referral to assure them that they did not have cancer. Patients felt they needed more information about breast symptoms and the referral process. Comments about communication with professionals, both good and poor, were frequent in their accounts, which contrasted with the absence of such concerns in the accounts of the professionals. The professionals thought that the 2-week rule was advantageous in reducing anxiety, but thought that disadvantages included longer waits for patients referred outside the rule and increased pressure on hospital services. Cultural changes, including increased patient assertiveness and 'breast awareness', were considered important contextual factors. General practitioners (GPs) were concerned about missing diagnoses in patients statistically unlikely to have carcinomas. CONCLUSION: Differences in emphasis were apparent, with patients wanting to be assured that they did not have cancer, specialists concerned both about increased workload and the impact on patients with cancers, and GPs anxious about missing diagnoses. The 2-week rule compromises professional autonomy, which partially accounts for the anger directed against it. There is a need for patients to have more information, and they place great value on good communication. All patient responders experienced significant distress while waiting to be seen.

Adult↗
PubMed2004

[Home nursing in the Netherlands since 1950].

This article describes home nursing in the Netherlands between 1950 and 2004. The developments in this period are described form the theoretical perspective on professions of Andrew Abbott: 'professions are exclusive occupational groups applying somewhat abstract knowledge to particular cases'. In 1950, home nursing was an all-round profession providing home nursing care and preventive care to all categories of patients, mainly in their own homes. It was - and still is - a profession situated in the 'periphery' of the health care system, where care and support to patients with pain, suffering and disabilities because of age or chronic illness are considered as belonging to a separate task domain, relatively independent of the mainly curative activities that are performed in the 'medical centre' of health care, especially in the academic hospitals. Typical compared to other countries is that an extensive network of private initiatives, in the form of Cross Organisations of different denominational signatures, existed in the Netherlands until 1990, covering the whole country with home nursing services. In that year, the provision of home nursing and home help were integrated and most home nursing organisations merged into large, regional home care organisations. In this article, six main social developments are described, that influenced the development of home nursing and resulted in the profession as it is now: a differentiated profession divided into different levels of care, working in an organisational, largely bureaucratic setting of home care organisations, where managers and external regional assessment organisations (RIO's) decide on the care to be provided. They now find themselves in a transmural setting, where boundaries between different forms of care no longer exist, and co-operation with other professionals, such as home helps, specialist nurses, GPs, and hospital physicians, is frequent. Currently, their professional autonomy and independent decision-making regarding diagnosis and therapy is affected, and elements of bureaucratisation and managementism (for example aspects such as time-writing) affect their daily work. However, home nursing can still be characterised as a relatively exclusive and independent profession, solving particular cases in the homes of patients by performing activities that are based on abstract, methodical knowledge.

History, 20th Century↗