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This study reaffirms the diversity and breadth of the veterinary profession. As it turns out, some of the furthest-reaching impacts of the veterinary medical profession were largely non-quantifiable. The veterinary medical profession had a substantial direct economic impact in Michigan during 1995. The total economic contribution of the veterinary medical profession to Michigan during 1995 that was attributable to expenditures on salaries, supplies, services, and their multiplier effect was approximately $500 million. In addition, the profession was associated with nearly 8,500 jobs (combined professional and lay positions). The veterinary medical profession was also considered to have an impact on the prosperity of the live-stock, equine, and pet food industries in Michigan, even though the economic contribution in these areas could not be directly quantified. Economic well-being of the individual businesses in these industries is directly related to the health and productivity of the associated animals, and improvements in output or productivity that accompany improved animal health likely carry substantial economic benefits in these sectors. In addition, progressive animal health management provides a crucial method of managing risk in the animal industries. Similarly, although the economic contribution could not be quantified, the veterinary medical profession enhances the safety and quality of human food through research, regulation, and quality assurance programs in livestock production, minimizing the risk of drug residues and microbial contamination. During 1995, approximately 5.3 million Michigan residents benefitted from the physical, psychological, and emotional well-being that accompanies companion animal ownership. By preserving the health and longevity of companion animals, veterinarians sustain and enhance these aspects of the human-animal bond. As Michigan enters a new century, it is likely that the state's veterinary medical profession will continue to make a highly valued societal contribution. Pets, equines, and food animals will continue to have prominent roles in Michigan for the foreseeable future, as will the human-animal bond, food safety, and medical research. Clearly, for economic and noneconomic reasons, it will be in the interest of the people of Michigan to seek opportunities to maintain and enhance the vitality of the state's veterinary medical profession. It was our hope that results of this study would provide university administrators, legislators, MVMA executives, and others with information needed to justify the ongoing provision of public support for the veterinary medical profession. In addition, we expect that the results will supply useful material for public relations and marketing campaigns by the MVMA and the Michigan State University College of Veterinary Medicine and will provide the media with public interest stories to promote the veterinary profession. Although this study considered the economic and noneconomic impacts of the veterinary medical profession only in Michigan, the results can provide an important reference point for educators, policy markers, and legislators in other states. In addition, this study could serve as a methodologic model for veterinary organizations in other states, or at the national level, to emulate.
In this article, the authors look at the relationship between pharmaceutical policy and the pharmacy profession with focus on pharmacy practice and pharmacists in the health care sector. Pharmaceutical policy encompasses three major policy inputs: public health policy, health care policy and industrial policy. In order to analyse and understand pharmaceutical policy, it is important to know how policymakers view pharmacy and pharmacists. The authors look at the issues that arise when policy regulates pharmacy as a business, and what this means for the profession. The perspective of pharmacy as a health care profession, as well as what it means when we view pharmaceutical policy in the context of the health sector labour market, is discussed. The authors also discuss how factors external to the profession are affecting its purpose and realm of practice, including the current trend in managerialism, and how the division of labour with other health professionals such as physicians and pharmacy assistants is affecting the pharmacy profession's position in the labour market. Next the authors look at ways in which the pharmacy profession has affected policy. Pharmacists have been instrumental in developing new and expanding roles for the profession, sometimes inspired by external events, but often as a result of their own prerogative. The pharmacy profession is encouraged to take a leading role in forming and contributing to policy, in this way making visible its contribution to society in general and public health in particular. If not, the profession will forever be reacting to policy and will remain at the mercy of policymakers and other strong actors in society.
OBJECTIVES: To understand how general (family) practice is being redefined and is redefining itself, from the perspective of policy elites, and to build an analytical framework. METHODS: Politicians, senior bureaucrats and executives of professional organisations were interviewed (1998-2000) about the impact of general practice reforms on the profession. The information gathered was thematically coded and used to advance an understanding of profession from an elite perspective. RESULTS: Four main aspects of profession were discussed by interviewees. These were cultural authority, profession's authority, social authority and professional autonomy. The elites interviewed reported a potential challenge to the cultural authority of general practice in both countries through moves to redefine it as something broader. The profession's authority was seen as having shifted, especially in Australia where new forms of representation for the profession have been established. Medicine was viewed variously as having its social authority challenged, maintained, or extended in the granting of expertise in health, and professional autonomy was regarded as having been restructured through policy change. CONCLUSIONS: Policy elites perceive that the authority and autonomy of general practitioners has changed but reform has not resulted in generalised losses for the profession. The framework developed here, which employed aspects of profession that arose as major themes, proved useful for examining the redefinition of profession and for generating policy insights in regard to possibilities for change and likely impacts.
Artificially supplementing our community water supplies with optimal amounts of fluoride to gain the benefits of a significant reduction in dental caries is a lesson we have learned from natural science, a lesson from nature we have appropriated for culture- and a very pragmatic lesson. Today, we have discovered through science additional principles of nature that can be instructive and that can be appropriated for the profession of dentistry's benefit. This paper reviews five principles of natural science and derives lessons for the profession from these principles. The principles include natural selection, environmental change, form follows function, symbiosis, and entropy. Lessons derived from these principles of natural science are, respectively: survival and thriving of the profession are dependent upon the environment; the status quo will not be maintained-the profession must acknowledge, encourage, and celebrate change; the form the profession assumes must be consistent with its function of serving society; the profession must acknowledge the interdependence and reciprocity existing in its relationship with society; and the profession must continuously, energetically, and creatively reconstruct and renew itself. The challenge before us is to transform dentistry into a profession that continuously anticipates environmental changes by energetically creating new forms or structures that will result in more effective fulfillment of our function: gaining the benefits of oral health for society.
This study advances our understanding of the relationship between the state and the medical profession in countries where health care services are used as instruments of economic and political control. As a general argument, we maintain that the corporatist nature of the Mexican state impedes the medical profession from achieving autonomy and control over its professional activities. In contraposition to medical professions in developed societies, the nature of the Mexican profession is shaped by state policies and by its reiterated efforts to act independently of the state's tutelage. We analyze this dynamic interaction through three different historical epochs that reflect the complexity and uniqueness of the Mexican medical profession. Whatever attempts the profession has made to control the medical curriculum, the licensing process, the market, or the specific laws that affect its own field, the Mexican state has responded with measures that systematically divide and antagonize the different factions of medical associations. The result is a highly fragmented and disenfranchised medical profession with dissimilar political, professional, personal, and academic aims. In the final analysis, the interests of the corporatist Mexican state prevail over the interests of the groups, including doctors. The evisceration of the medical corps by the Mexican state results in a profession with low salaries, higher rates of unemployment, atomization in terms of political representation, and heavily co-opted medical organizations that seem to neglect the overwhelming health care needs of the Mexican people.
The present article presents the sociological analysis of the nursing profession, focussing the specificities of the profession on the basis of the component elements of a profession, according to the theoretical system of the sociology of professions. At the end of the 20th century and the beginning of the new millennium, nursing faces crucial questions for the profession, which bring back the need to restructure the strategic considerations that make up the political agenda of the nursing profession. Specific knowledge, professional qualification, particularities of the work process, monopoly of the professional exercise, and the configuration of the hierarchy of the nursing team are some of the items dealt within this article. As one of the essential professions in the health area, nursing needs to reach the next century with a new perspective, knowing how and in which conditions it will develop in a context of paradigmatic changes. Considering this new context, a political agenda for nursing professionals will have to contemplate the several aspects that make up a profession, that is, specific knowledge, exclusive labor market, form of organization, among others.
BACKGROUND: Selection into and out of a profession is a known phenomenon in jobs such as hairdressing, in which the workers are exposed to agents and conditions capable of causing work-related symptoms and diseases. OBJECTIVE: To assess the risk for departure from the profession due to health and other reasons among hairdressers as compared with women engaged in commercial work. METHODS: We used a self-administered questionnaire to provide data on 3484 female hairdressers and 3357 referents with regard to their reasons for leaving the profession during the 15-year follow-up period of 1980 1995, for which the relative risks (RR) and 95% confidence intervals (CI) were calculated. The data were collected in August 1995. RESULTS: Of the reasons studied, only the concern for health increased the risk of leaving the profession (RR 1.33; 95% CI 1.16-1.52) among hairdressers. The risk of hairdressers having to leave the profession (1) because of asthma or hand eczema was 3.5 times as great as that found among the control group, (2) because of a strain injury of the wrist or elbow was 2.7 times as great, and (3) because of diseases of the neck or shoulders was 1.7 times as great. The risk of leaving the profession was approximately 20% higher for hairdressers who had suffered at some point in their lives from an atopic disease. CONCLUSIONS: Hairdressers suffering from atopic diseases, hand eczema, and strain injuries of the elbow and wrist are at higher risk of leaving the profession. Active modes of intervention are needed to maintain their working ability. The tools available in the occupational health service are: information on hazards, optimization of working conditions, personal protection, and timely medical care and rehabilitation.
Most of professional ethics is grounded on the assumption that we can speak meaningfully about particular, insulated professions with aims and goals, that conceptually there exists a clear "inside and outside" to any given profession. Professional ethics has also inherited the two-part assumption from mainstream moral philosophy that we can speak meaningfully about agent-relative versus agent-neutral moral perspectives, and further, that it is only from the agent-neutral perspective that we can truly evaluate our professional moral aims, rules, and practices. Several important changes that have occurred, or are currently taking place, in the structure of the health care professions, challenge those assumptions and signal the need for teachers of professional ethics to rethink the content of what we teach as well as our teaching methods. The changes include: influences and critique from other professions and from those who are served by the health professions, and influences and critique from professionals themselves, including increased activism and dissent from within the professions. The discussion focuses on changes that have occurred in the health-related fields, but insofar as similar changes are occurring in other professions such as law and business, these arguments will have broader conceptual implications for the way we ought to think about professional ethics more generally.
CONTEXT: Many rural and inner-city communities in the United States have persistent shortages of health professionals. In addition, health services are increasingly delivered in community-based settings by interdisciplinary teams. Yet, health professions students in the US continue to receive most of their training in urban hospitals. OBJECTIVE: To assess the extent to which national and state government programs in the US that fund health professions education provide financial resources for community-based and interdisciplinary education in the health professions. METHODS: Literature review. FINDINGS: Most national and state government funding provided to health professions schools and clinical training sites in the US is not targeted to community-based and interdisciplinary education. Nationally, the Bureau of Health Professions, however, does administer some targeted grant programs. In addition, a number of states are addressing these needs through targeted appropriations to health professions schools and Medicaid payments to clinical training sites. RECOMMENDATIONS: The US experience with government funding of health professions education suggests several questions that policymakers in other nations should consider and several principles for developing effective policies to promote community-based and interdisciplinary education.
Many improvements in orthopaedic care have been enabled by the relationship that exists between the orthopaedic profession and the orthopaedic industry. This relationship is multifactorial and includes new technology development, medical education, orthopaedic research, and patient education. Acting individually and collectively, the profession and the industry advance their standing by focusing on improved patient care. Although the industry, the profession, and the patient have many shared interests, they also may have real or potential conflicts of interests. The patient's interest in the quality of treatment outcome is shared by the profession and industry. However, the interests of the profession may include issues related to the success of their practices, management of their time, and advancement of their skills. Industry's interests, in turn, include the support of their customers and the success of their businesses. Conflicts of interest between these parties are potentially neither avoidable nor undesirable. Managed well, the relationship of the orthopaedic profession and the industry achieves the goals of each while advancing patient care. As the profession and the industry each experience change, continued attention should be directed to ensuring that the interest of each is advanced only in the context of serving the interest of the patient with musculoskeletal disorders.
This article examines the question of whether or not nursing is or should be a profession. The conclusion is based primarily on an analysis of what constitutes a profession and an empirical study of some nursing practices and attitudes. The analysis of professions recognizes three prominent models in sociology: trait, functional, and power or control. It bypasses these in favor of a "cluster concept," which asserts that the public has a number of expectations of an occupation before it will bestow the status of profession upon it. We then give an analysis of some of the results of the survey of a sample of Missouri registered nurses. The gist of the data is said to reflect the facts that these nurses think nursing is or should be a profession, but that other factors tend to show that nursing lacks the requisite cluster to substantiate the claim to be a profession. We conclude that nursing should perhaps not be a profession since it has been a bastion of the "ethics of compassion" in a world that is increasingly beset by an "ethics of competence."
BACKGROUND: More than 100 years after its inception the chiropractic profession has failed to define itself in a way that is understandable, credible and scientifically coherent. This failure has prevented the profession from establishing its cultural authority over any specific domain of health care. OBJECTIVE: To present a model for the chiropractic profession to establish cultural authority and increase market share of the public seeking chiropractic care. DISCUSSION: The continued failure by the chiropractic profession to remedy this state of affairs will pose a distinct threat to the future viability of the profession. Three specific characteristics of the profession are identified as impediments to the creation of a credible definition of chiropractic: Departures from accepted standards of professional ethics; reliance upon obsolete principles of chiropractic philosophy; and the promotion of chiropractors as primary care providers. A chiropractic professional identity should be based on spinal care as the defining clinical purpose of chiropractic, chiropractic as an integrated part of the healthcare mainstream, the rigorous implementation of accepted standards of professional ethics, chiropractors as portal-of-entry providers, the acceptance and promotion of evidence-based health care, and a conservative clinical approach. CONCLUSION: This paper presents the spine care model as a means of developing chiropractic cultural authority and relevancy. The model is based on principles that would help integrate chiropractic care into the mainstream delivery system while still retaining self-identity for the profession.
PURPOSE: To provide a working definition of professionalism for medical educators. SUMMARY: Thus far, the literature has not provided a concise and inclusive definition of the word profession. There appears to be a need for one as a basis for teaching the cognitive aspects of the subject and for evaluating behaviors characteristic of professionals. Furthermore, a knowledge of the meaning of the word is important as it serves as the basis of the contract between medicine and society, and hence, of the obligations required of medicine to sustain the contract. A definition is proposed based on the Oxford English Dictionary and the literature on the subject. It is suggested that this can be useful to medical educators with responsibilities for teaching about the professions, professional responsibilities, and professional behavior. CONCLUSIONS: The proposed definition is as follows: Profession: An occupation whose core element is work based upon the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning or the practice of an art founded upon it is used in the service of others. Its members are governed by codes of ethics and profess a commitment to competence, integrity and morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of self-regulation. Professions and their members are accountable to those served and to society.
The main cause for nursing shortage in the world is that nurses are withdrawing the profession. However few research has been carried out to prove this. This study investigates nurses' permanence in job and their motives for withdrawing it. Researchers tried to contact 1112 nurses who enrolled the profession after finishing the undergraduate nursing course at the University of São Paulo at Ribeirão Preto College of Nursing, Brazil, in the period from 1957 to 1990. They were not able to contact 95 nurses (8.54%) from the total. Therefore, 1017 (91.46%) were contacted by mail, telephone or interview to answer a questionnaire, 808 (72.66%) answered, 194 (17.45%) did not reply, 4 (0.36%) refused to answer and 11 (0.99%) died, generating the following data: 19 (2.35%) never worked, 661 (81.81%) are working in the profession, 102 (12.62%) worked and withdrew nursing, 26 (3.22%) retired. Considering this group, the analysis showed that the percentage who left the profession is small, nevertheless other studies are suggested in order to enable the comparison of these results. The motives for their permanence are their attachment to the profession, even though they say that their work is not recognized and they are badly paid. The reasons for withdrawing the profession are family and personal problems as well as constant changes in the schedule and general frustration. In sum, nurses love their profession and would like to continue working. Some of them are returning and asking for better conditions.