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PubMedDate not supplied

Registered post.

The professional work of nurses and doctors is subject to a rigorous statutory regime of scrutiny. A pilot scheme in Scotland will shortly test out a new register for healthcare support workers.

Employment↗
PubMed1981

[Psychiatry and the medical monopoly : professionals under guardianship, the population held hostage.].

This article is the condensed form of a report done by a group of the Quebec Social Affairs Professionals' Union. After reviewing the key events between 1960 and 1980 for the professional autonomy of paramedics, the authors describe their current struggle to free themselves from the grip of psychiatrists and to have their autonomy recognized. Their efforts in this direction as well as the legal obstacles are described. They conclude with a series of recommendations for improving the present situation.

English Abstract↗
PubMed1991

Influencers of career choice among allied health students.

This study focused on the factors that influence students' choice of an allied health profession. A survey of 153 students in three allied health programs at the University of Connecticut revealed that "the need to help others," "prestige," "professional autonomy," "opportunities for advancement," "income potential," and "the effect of the specialty on family and personal life," were the major influencers of career choice among allied health students. Only a few students regarded malpractice suits and AIDS as negative influencers. While medical laboratory science majors regarded these as important factors, dietetics and physical therapy majors did not. The article suggests further use of these findings by program directors and career counselors.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Professional culture and organizational morality: an ethnographic account of a therapeutic organization.

An ethnographic exploration of the social reality of a counselling and training institute points to the profound impact of the therapeutic paradigm on the 'patterned regularities', the general principles, rules and daily practices, in other words, the organizational morality. The limited house-rules or practices emerged mainly as 'enabling conditions' to let professional autonomy prevail and to maintain the game rather than to prescribe behaviour. Organizational rules, structures, mechanics served as a platform for negotiations among different groups of 'provinces of meaning'. These negotiations do not necessarily show any sense of organizational logic or administrative rationality. Perhaps the opposite is true. Loosely coupled interactions and consensual validation rather than goal-oriented thinking appeared to be the predominant organizational occupation. The irrational, at times even ironic dynamics operative in organizational morality are nevertheless meaningful. They function as 'mapping' and sense-making devices and can be seen as vehicles for reflecting and ordering underlying meanings.

Counseling↗
PubMed1990

Free enterprise, professional ideology, and self-interest: an analysis of resistance by Canadian physicians to universal health insurance.

Under Canada's universal health care system, physicians are remunerated through government-run health insurance plans; a private market for physicians' services is virtually nonexistent. A proposal to ban the practice of extra-billing, whereby some physicians billed patients for amounts over and above insured rates, met with physicians' opposition. The particular constellation of legislative, social, and political events that followed the proposed ban presented a unique opportunity to explore the nature of the medical profession's resistance to encroachment on professional autonomy. The results of this survey of physicians in four specialties (N = 313) in metropolitan Toronto suggest that resistance to universal health insurance is complex; it involves a prevailing social ideology among physicians, which happens to be antiwelfare and conservative generally, entangled with economic self-interest and a specific set of beliefs about medical practice and physicians' rights and privileges.

Attitude of Health Personnel↗
PubMedDate not supplied

Dentists' outlook toward their profession.

Given the dramatic changes presently occurring in the practice of dentistry, it was the purpose of this research to examine the outlook held by practicing dentists toward their profession. Through use of a mailed questionnaire, a national sample of general and pediatric dentists was surveyed. A 12-item Likert scale was used to measure dentist outlook. Additionally, dentists responded to questions dealing with conditions of their practice. Respondents were most positive about the professions' accomplishment in reducing caries by promoting the use of fluorides. The majority also felt that decreased time spent providing restorative services would lead to increased time spent providing other services, that greater use of auxiliaries would produce increased income, that the ADA's proposed marketing plan would have a positive effect on the public, and that research findings were relevant to the private practice of dentistry. Three items received negative responses. These items related to the oversupply of dental manpower, the detrimental effects of the increase in competition among dentists, and the decrease in professional autonomy. Additionally, four practice variables were found to be related to dentist outlook. Outlook became more favorable with increasingly more positive income change over the prior year, with increasing numbers of employees, and with increasing practice business. Finally, the longer a dentist had been out of dental school, the more positive his or her outlook was likely to be.

Attitude of Health Personnel↗
PubMed1979

Control, participation, and the British National Health Service.

The experience of Britain's National Health Service since 1948 suggests that there is a conflict between different social values and policy aims, and that progress toward achieving more community or worker control is constrained by the pursuit of other desired objectives. The egalitarian ideology of the NHS emphasizes central control to achieve a nationally equitable distribution of resources. Emphasis on coordination between the NHS and other social services limits freedom of action. Democracy as accountable policy-making on a national scale may therefore be incompatible with democracy as direct control, whether by community or workers. To encourage participation means accepting diversity in the provision of health care and the multiplication of small, self-governing units. Similarly, worker control is professional autonomy writ large and may therefore conflict with community control.

Community Health Services↗
PubMed1989

Nonresident aliens and access to organ transplant.

The present policies for allowing nonresident aliens access to organ transplantation are neither fair nor consistent. They apply only to some transplants, and they take no account of their discriminatory effect among foreigners. Much less do they deal with the meaning of fair access, given our complete ignorance of the number and character of those outside the United States in need of a transplant. Most strikingly, present policy prohibits discrimination based on where a patient lives in part by imposing it based on where the patient is to receive a transplant, here or abroad. The one-list policy is more a result of political compromise, institutional interest, and the misapplication of the principle of professional autonomy than of any consistent policy or logic. In this mishmash of justification, one argument does stand out--that sharing organs with nonresidents ought to be done on the grounds of charity. Yet even here, the present form of this position is inadequate, perhaps because it has not been systematically applied to organ distribution issues. An argument for charity contains two elements, the nature of the obligation and the subject on whom the obligation rests. In its ordinary form, the obligation of charity requires a transfer of resources from wealth to poverty. A more subtle and complex formulation is required to apply this obligation to the conditions of universal poverty pertaining in organ transplantation. It remains to be seen if this is possible. There is also the question of to whom the argument must be made. A minimal requirement of charity is that one shares one's own resources, not those of another. Inevitably, this brings us to the perennial question of organ distribution: Whose organs are these? We can easily say whose they are not; they do not belong to hospital administrators, academic researchers, transplant surgeons, or organ procurement agencies. Insofar as they are national resources, Congress may be able to stake a claim; but insofar as giving organs to nonresident imposes sacrifices on residents awaiting an organ, perhaps they should be consulted. And their right to refuse must be accepted, for in organ distribution, the only real charity the well have a right to dispense is not to judge the sick.

Emigration and Immigration↗