Physician Resistance to Innovations: The Case of Contract Medicine

Abstract

Physicians' assessments of contract medicine arrangements such as health maintenance organizations (HMOs) are considered in light of innovation diffusion theory and changing professional relations in medical care. Data from a national sample of physicians reveal that physicians practicing in HMOs differed from others in that they were more likely to be primary-care practitioners and politically liberal; they were also more likely to have thought that a physician surplus was emerging and that HMOs offered better working conditions. They did not differ from other physicians in job satisfaction. After considering differences between the two groups, the research examines how physicians, who did not practice in HMOs, viewed such contract medicine arrangements. Findings indicate that physicians in fee-for-service (FFS) practices felt that working conditions and service quality in HMOs are highly related and are better in FFS practices than in HMOs. In addition, physicians who anticipated heightened competition from HMO development were more likely to favorably evaluate HMO service delivery. The findings suggest accommodation to an organizational innovation if it is seen as preserving practice autonomy, but limited acceptance otherwise.     

Social Work Roles in Drug Treatment with Youth

ABSTRACT

Social workers working with youth, who are prescribed psychotropic medication, are routinely faced with tasks pertaining to psychopharmacologic treatment. Little is known, however, about how these workers contribute to the medication treatment process or the impact of their contributions. The purpose of this national survey of social workers practicing with youth was to explore three areas: (1) the frequency of medication-related functions with adolescent clients; (2) the worker, client, and contextual factors associated with greater involvement; and (3) social workers' perceptions of the effects of greater involvement on treatment processes and outcomes. Our findings suggested that in relation to medication treatment, social workers more frequently interfaced with clients than physicians, and that various treatment context and individual factors are associated with greater involvement. Social workers also perceived their involvement as associated with some desirable treatment processes/outcomes, especially the inclusion of adolescents in decision-making.     

Sex Differences in Sociology Specializations, 1975–1985: Women's Liberation to Ghetto Specialization

Abstract

This report explores the division of labor by sex in sociology. Using the Guide to Graduate Departments for the years 1975, 1980 and 1985, first-cited specialty areas for all women and a one-fifth sample for men were obtained. Comparison of these specialty areas for women and men suggests that a division of labor by sex exists in sociology. Further, the correlations between specialty areas for men and women are decreasing over time, indicating an increasing division of labor by sex. Of particular interest are: 1) the nearly exclusive participation of women in Gender Studies and the increase of women over time who choose this as a first-cited specialty; 2) the decline in the core area of Methods by both men and women; 3) the decline in the core area of Theory by women.     

An exploratory factor model of social area analysis

Social ecology theory promotes the idea that the social structure of any given area influences the behavior of the social group in that area. One model of ecological theory is Shevky and Bell's social area analysis, which presents three constructs to describe and measure urban differences. Shevky and Bell label these constructs social rank, urbanization, and segregation. However, the measures (and labels) originally proposed by Shevky and Bell have been altered across repeated applications. This study is a test of the validity of the three‐construct model using variables popular in current research. The results of this study reveal that a four‐factor model provides a better fit, suggesting that a revision of social area analysis theory is in order.     

A National Survey of Graduate Education in Psychopharmacology: Advancing the Social Work Perspective on Psychiatric Medication

ABSTRACT

Social workers’ unique skills and professional perspective can contribute to improved practices in psychopharmacology, yet it is unclear how social work programs prepare students for this area of practice. This study examined instruction of psychopharmacology through a national Web-based survey of MSW program directors and instructors of psychopharmacology content (n = 171). Nearly two-thirds (63.7%) reported their program integrates psychopharmacology usually into one or two existing courses, whereas 20.5% indicated their program offers a stand-alone course. Lack of faculty expertise and having no room in the current curriculum structure were identified as the top barriers for programs not offering any psychopharmacology content. The profession’s critical, social justice, empowerment, client-centered, and systems perspective appears to ground the teaching of psychopharmacology in social work programs.     

Critiquing a Colleague's Forensic Advisory Report

Abstract

The purpose of this article is to provide a protocol within which to frame a critique or critical review of a colleague's custody evaluation. While we think that the structure and logic of the following protocol may be applied to other forensic evaluations, our focus here is on the specific forensic specialty area of child custody and parenting access evaluations (CCEs).     

Volunteerism and Social Work Educators: Findings from a National Survey

Abstract

This study reports the results of a national survey designed to identify the nature and levels of volunteer work that social work educators contribute to the social welfare sector. Findings reveal that nearly all social work educators engage in formal volunteer work and perform a variety of roles in human service agencies. The most common volunteer activities are advocacy, administration and consultation. The least common volunteer activities are evaluation, data management and emergency services. Study results also indicate that tenure status and primary teaching area are positively associated with the amount and type of volunteer work performed.     

Pathways to social work supervision

ABSTRACT

Social work research and literature in the area of supervision tends to focus on the supervision of field education students. Less attention is given to the supervision of social work practitioners and there is almost no information that examines how social workers become supervisors. This exploratory study interviewed 27 practicing social work supervisors across different fields of social work practice in Western Canada. The participants included 15 supervisors with a graduate degree and 12 supervisors with an undergraduate degree. The supervisors completed a brief questionnaire that was followed by a structured interview. Supervisors were asked how they came to be social work supervisors. Thematic analysis of the supervisors’ responses revealed three pathways to supervision: task exposure, supervision by happen chance, and deliberate decision. The responses suggested that additional focus on supervision might be included in undergraduate education and that universities, professional associations, and employers pay more attention to succession planning.     

Technology Investment Trends

SUMMARY

Social service agencies across the country are investing in a wide range of technological, business process reengineering, and organizational change projects. These projects include:

? ? using technology to connect social workers to enable collaborative case management;

? ? building databases with sophisticated querying applications that allow quick, effective decision making at the front-line and management levels; and

? ? expanding the number of ways clients can access services through the use of the Internet, kiosks, electronic benefit transfers, etc.

Successful projects have a clearly identified business need and a strategy for addressing that need. This strategy includes understanding the process, organizational and technological context, evaluating alternative means of meeting the need, and developing a solid program management plan.     

Reconsidering participatory action research for organizational transformation and social change

Abstract

Considering the notion of vagueness of organizational and social contexts during the processes of organizational transformation and social change, a dramaturgical model of organizations is proposed for facilitating the process of organizational transformation and learning in local and contingent contexts. Our strategy for participatory action research (PAR) is suggested for appreciating the importance of the multiple uses of research methods, hence the need to come to terms with pluralism and holism. In this paper, the design of participant-driven research, using the post-structuralist thought of Michel Foucault and Gilles Deleuze, is critically reviewed.     

Shaping Street-Children Organizations Across the Americas

Abstract

Covenant House, a non-governmental, social action organization assisting homeless children in the United States is compared and contrasted with its Latin American counterpart organization, Casa Alianza, which services street-living and street-working children throughout Mexico and Central America. Although Covenant House and Casa Alianza share a common mission: to protect children and guarantee their rights through promoting social justice, clear differences in organizational structure, program philosophy, intervention techniques and client characteristics are evident ltural contexts within which both organizations are embedded reveals how surrounding macrofactors can influence and uniquely shape social action organizations in their efforts to develop and deliver systematic and indigenous responses to the homeless, street-children population throughout the Americas.     

Paradigm for the Generalist-Advanced Generalist Continuum

Abstract

Social work faculty and practitioners have long argued the definition and parameters of the advanced generalist concept. This article explores the concept of generalist-advanced generalist in practice and in education and advances a paradigm for framing the Bachelor of Social Work-Master of Social Work educational continuum. It further argues that the generalist-advanced generalist continuum is particularly well suited to practice in small towns and rural areas. It further argues that the generalist-advanced generalist continuum is particularly well suited to practice in small towns and rural areas because it provides an educational strategy for preparing both entry level and advanced level social workers with the full range of skills needed for practice in these environmental contexts because content on advanced generalist practice is infused in all foundation, field instruction, and areas of specialty in the advanced curriculum.     

The Effect of Education on the Sexual Beliefs of Family Physicians

ABSTRACT

Objectives: The purpose of this study was to determine the effect of education regarding a healthy sex life on family physicians’ ideas concerning sexuality. Methods: A 3-hour interactive education program was prepared for family physicians. Thirty-seven family physicians and 21 students specializing in family medicine volunteered to participate in the program. Results: The level of agreement expressed by participants with 25 of the 31 dysfunctional sexual beliefs in the study decreased after training. Only marital status played a significant role in predicting change percentages in sexual beliefs. Conclusions: We think that programs concerning a healthy sex life should be added to physicians’ training.     

Computer Diffusion and Worker Empowerment

Abstract

Much anecdotal material describes various human impacts of computer adoption within the social work profession, however, there is scant research which confirms or challenges these assumptions. This article describes a study which investigates the diffusion of computers into the social work profession in terms of empowerment as an individual outcome for workers. A questionnaire returned by 520 social workers provided data on organizational computer diffusion, organizational centralization, and the Social Worker Empowerment Scale. Workers in organizations where computer diffusion was more advanced, and those in more decentralized decisionmaking environments were found to be more empowered.     

Teaching Successful Community Practice in Social Work

ABSTRACT

This article identifies and addresses a severe problem in the management of community practice projects of students in their second and third year in the Undergraduate Social Work program at the University of Haifa School of Social Work; namely, the current binary evaluation method based on total success or failure of the project.

Using a systems approach, this study creates a framework by which to ensure effective and positive outcomes for community practice projects carried out by undergraduate social work students (Freund, Arkin & Saltman, 1999). This framework is unique in that it draws on knowledge gained from organizational and community theories, as well as instructional theories for teaching social work practice.

The proposed framework includes three components that describe the factors necessary to help transform the student's learning experience: the organization's characteristics, the student's resources, and the evaluative measures.

This inter-conceptual approach enhances the ability of the instructor, the student, and the organization to build an appropriate organizational foundation for students operating communal programs. The underlying assumption is that an integrative approach promotes a better understanding of the components essential for building and evaluating social plans conducted by social work students.     

THE GLOBALIZATION OF A MINOR SPORT: THE DIFFUSION AND COMMODIFICATION OF MASTERS SWIMMING

ABSTRACT

We examine the global spread of Masters Swimming (MS) focusing on the economic, social, and demographic conditions associated with its initiation in the United States and its international growth. We characterize MS as a modern sport and look at its subcultural form, organizational structure, practices, and early pattern of organizational growth from bottom to top. Then we describe the top down role of La Federation Internationale de Natation Amateur (FINA) in supplying legitimacy, resources, organizational coherence, and corporate sponsors to spread the sport among FINA members. By establishing mutually beneficial relations with corporate sponsors, MS rapidly commodified and diffused to countries and territories with middle to high socio-economic development.     

From pipeline to practice: Utilizing tracking mechanisms for longitudinal evaluation of physician recruitment across the health workforce continuum

PurposeArea Health Education Centers work with community partners to prepare a diverse, primary care workforce particularly among rural and underserved communities. We set out to assess our impact on the physician workforce across a multitude of short-term, intermediate, and long-term benchmarksMethodWe used a comprehensive evaluation scaffolding to assess benchmarks of success across the workforce pipeline including short-term (i.e. pre-medical intent to pursue a health career or medical students’ intent to practice in primary care), intermediate (college matriculation and primary care residency match rates) and longterm measures (licensure and medical practice location of program participants).ResultsWe identified significant findings in each part of the AHEC program continuum. Among our alumni, we found a significant increase in the pre-medical learner’s intent to pursue a health care career. Among medical students, we found a significant increase in intent to practice in primary care, rural areas, and medically underserved communities and a high rate of primary care residency match (compared to peers). Approximately one-third of licensed physicians are now practicing medicine serve in an underserved communityConclusionsOur findings confirm the value of longitudinal evaluation on confirming that participation in an AHEC supported program strengthen the physician workforce development.     

Gender roles and social control

Drawing upon social control theory in criminology, this paper examines the relationship between gender roles and the inhibitors of deviance. We develop and test hypotheses that “traditional” females, defined in terms of either position in the social structure or gender‐role attitudes, perceive higher levels of three types of sanctions assocíated with crime than do males; while “nontraditional” females are similar to males in their perceptions of sanctions. Results indicate that while changing gender roles and gender‐role attitudes affect perceived threats of guilt‐feelings and social stigma, they do not appear to influence women's perceptions of legal sanctions.     

Towards a Comprehensive Framework for Understanding the Social Environment

SUMMARY

This paper presents a conceptual framework for selecting and organizing concepts of the social environment. It expands upon the traditional Human Behavior and the Social Environment perspectives used in social work curricula in the United States by identifying how a macro-systemconsisting of the intersection of four societal forces (social justice, social problems, social policy, and the political economy) works to influence a micro-systemof community, organizational, and group dynamics. In this framework, the impact of the macrosystem is mediated by collective responses of partnerships, alliances, and networks convened to address these forces. The framework is useful for understanding the complexity and uncertainty of the social environment in modern society with specific reference to: (1) how macro-system forces work to shape a constellation of community and organizational concerns, (2) how collective responses that seek solutions can be understood as instruments for achieving meaningful social change, and (3) how micro-systems concepts of structure (stages of development, systems of exchange, and diversity) and process (power and leadership, conflict and change, and integrating mechanisms) can inform practice.     

Discovering Women with Disabilities

Abstract

The unique characteristics, strengths, and challenges facing women with disabilities are discussed. A feminist perspective is used to identify and understand the implications for developing policy, and providing services for and practicing with women with disabilities. Rather than utilize a traditional paradigm that places the “problem” within the individual woman with a disability, disability is explored within a social context.