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Results for “Professional Autonomy”

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PubMed1989

[Job satisfaction of physicians in academic and general hospitals].

Based on a study of 20 medical departments (general surgery, internal medicine, radiology) an analysis is presented of variables which may account for differences in work satisfaction. The results show: (a) (experienced) work load correlates negatively with work satisfaction; (b) satisfied physicians define their medical domain more broadly than dissatisfied physicians. Besides, they do not regard their salary as an important aspect of their work. In general, radiologists are most satisfied with their work, internists least; medical specialists are more satisfied than residents. In the discussion it is argued that hospital physicians prefer regularity in their work, combined with a professional work climate. In terms of the growing bureaucratization of the physician's work it is concluded that satisfaction is positively influenced by standardization of work processes and negatively by external pressures which limit professional autonomy.

Academic Medical Centers↗
PubMedDate not supplied

Coping with change.

The human brain is geared to detecting change, yet we often fear change. This may be because fear of change and a failure to cope with the change come from feeling that the origins of change are out of our control. Rather than coping with change, nurses should be effecting change in order to ensure the best patient care and their own professional autonomy. Below, the author takes an inward look at how institutions and traditional practices perpetuate these feelings and at the remedies.

Adaptation, Psychological↗
PubMed1986

1986 and beyond. Nursing's future.

Predicting the future is a risky effort for nursing administrators. What we can do is reevaluate our past and learn how the lessons of prior eras can help us understand the trends affecting health care and nursing and plan strategies for moving nursing forward. Specifically, to move forward we must effectively deal with our image, mechanism for educating students, attainment of public accountability and professional autonomy, political skills, and becoming more actively involved in research to document the value of nursing.

Aged↗
PubMed1988

Medical politics and Canadian Medicare: professional response to the Canada Health Act.

The Canada Health Act of 1984 served as a lightning rod for profession/government conflict, culminating in a 25-day doctors' strike in Ontario. The act was perceived as threatening medical dominance and professional autonomy in its prohibition of user fees and extra billing. A post-strike survey of 2,397 physicians across the provinces, however, reveals important limits to physicians' ideological support for an unregulated medical market place. Rather, there are divisions within the profession on how to translate commitment to autonomy into appropriate policy objectives and political strategies.

Attitude of Health Personnel↗
PubMed1988

Doctors, partitocrazia, and the Italian state.

Political and economic forces are determinants of the social position of the professions in any country, but in Italy the political parties exercise such extensive control that no profession can function independent of political party decision making. The medical profession thus developed in close connection with the state, reflecting in the split between generalists and specialists with its professional organization (ordini) differences between the political parties. The attempt of the state to rationalize the health system and control costs through the mechanism of the Italian national health service had the ironic effect of unifying the profession in opposition and thereby increasing its strength. The case of Italy shows the standard conceptual models of professional autonomy to be incomplete because they fail to account for the central role of political parties.

Education, Medical↗
PubMedDate not supplied

Psychosocial aspects of terminal care. A preliminary study of nurses' attitudes and behaviour in a general hospital.

American research has shown that dying patients in general hospitals are unpopular with health care personnel who withdraw from them socially while maintaining adequate physical care. Some of the reasons for this may be doctors' control of patient care and their own fears of death or perception of patient death as failure. Most doctors would not permit patients to know of a poor prognosis and this often leads to 'closed awareness' in which both nurse and patient are aware of the eventual outcome, but the nurse is forbidden to discuss this and so cannot encourage 'dangerous' conversation in the patient. This study was designed to replicate some of the American findings and confirmed that nurses are ill-prepared to deal with death, withdraw socially from terminal patients and have no authority to discuss dying. The findings are discussed in terms of nurse education and implications for professional autonomy and responsibility.

Attitude of Health Personnel↗
PubMed1987

Quality: from imperatives to innovations.

I have outlined the quality issues facing critical care nurses today and have also presented some challenges for the future. Critical care nurses must now enter a new era characterized by unification, collaboration and involvement, increased professional autonomy, and caring to meet the customer's expectations for quality in fact and quality in perception. Through innovation, critical care nurses can control the pace of change and influence quality in critical care. Recall the kaleidoscope and remember that its intent is to make the whole seem more than the sum of its parts. The image on the horizon is a dynamic and powerful nursing profession as a whole, with critical care nurses assuming an essential and more important role. In fact, the image on the horizon looks bright to me.

Consumer Behavior↗
PubMed1981

Counseling families and deciding care of severely defective children: a way of coping with 'Medical Vietnam'.

Medical paternalism supported by hospitals and courts has been, will be, and should be used in those few situations where clearly incompetent or irresponsible parents resist treatment that health professionals generally agree is needed and effective. If used in other circumstances, it is likely to erode family and professional autonomy and bring about an oppressive "medical Vietnam" (costly, sometimes abusive, use of technology to ensure biologic existence with little regard for quality of child and family life and competing interests). Families must be relied upon to help resolve most complex tragedies because there is no better alternative. They are likely to become stronger if they participate in decisions for care of their severely defective children. Such decisions logically include those for life or death.

Conflict, Psychological↗
PubMed1995

Hospitals versus physicians, POs versus PHOs: the providers' struggle for control of managed care contracting.

The great majority of U.S. hospitals are at one stage or another of physician-hospital organization (PHO) formation, in an attempt to accomplish hospital-physician integration. Since early 1994, however, significant numbers of physicians have begun to form their own organizations and confederations. The physician organization (PO), a more highly evolved form of the independent practice association, usually covers a wide geographic area, and it can cross hospital boundaries. Founders of the PO nearly always wish to position the organization to negotiate "master contracts" directly with payers and employers, rendering hospitals mere subcontractors. This article examines the evolution of physician attitudes about PHOs and POs, and also gives insight into the details of PO formation. The author outlines barriers to PO formation, and draws a picture of a momentous industrywide struggle for control between physicians and hospitals.

Capitation Fee↗
PubMed1994

Accountability--its implications for theatre nurses.

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC), in its revised Code of Professional Conduct (June 1992) states that, 'As a registered nurse ... you are personally accountable for your practice', and goes on to identify sixteen clauses which define how we are now obliged to exercise that accountability. The inclusion of the word 'personally' in the revised text places the responsibility for professional development and standards of care firmly in the hands of the individual practitioner. The aim of this paper is to explore the relevance of professional accountability to the nurse practitioner in the operating department, and how the care she gives, the skills she uses and her relationships with other members of the theatre team, are affected by its implications.

Humans↗
PubMed1994

Professional representation and the free-lance medical illustrator.

We researched factors related to the success or failure in working relationships between free-lance medical illustrators and artist's representatives. In the fall of 1992, surveys were mailed to 230 medical illustrators; 105 (46%) completed surveys were returned. Respondents were divided into three categories: 1) medical illustrators currently represented, 2) medical illustrators previously represented, and 3) medical illustrators who had never been represented. Comparisons made among illustrators from the three groups included business practices, clientele, experience, and self-promotion techniques. These comparisons revealed notable differences and similarities between the three groups and were subsequently analyzed to identify the characteristics of medical illustrators who would benefit from professional representation.

Medical Illustration↗