The ups and downs of managing employed physicians

The number of employed physicians is growing, posing new challenges to physician executives. Managing employed physicians begins during the hiring process. Once the new physician is on board, an organization should appoint a mentor to help the new employee adjust. Compensation remains a consistent challenge in most organizations with employed physicians. One of the most popular compensation models involves a market-based salary with the opportunity for a performance bonus.     

Guidelines for contingency approach to planning

In an earlier article the author discussed the contingency approach to planning as a flexible managerial tool making it possible to find a good fit between the planning process and the organization. In the present article the contingency approach is applied to the product life cycle to show how the different steps in the planning process can be varied as the situation changes. The contingency approach to planning can be used in a similar fashion for a product line, a product division, or the entire organization.     

The information revolution: opportunities and pitfalls for patients and providers

The Information Revolution is changing everything in our world. Although this era is developing and evolving, some have described networks, globalization, diffusion of power away from professionals, and information overload as direct results of the Information Revolution. These megatrends are affecting every person and every organization in the world, and this article examines them to see how they might affect medicine and the delivery of health care in the millennium. What is truly significant about the changes brought about by the creation of cyberspace is that through computers, digitized information can be inexpensively and quickly transmitted anywhere in the world. Many of the traditional ethical and professional standards of medicine are feeling the strain of being applied to the strange, unfamiliar world-cyberconsultations and other virtual medical applications are explored. Physicians who understand this revolution will have a far better chance of controlling their destinies--and more importantly, aiding their patients in the quest for good health.     

Related party transactions under a contingency perspective

Related party transactions (RPTs) are transfers of resources, services or obligations between a reporting entity and a related party (IASB 2009); criteria for a related party definition may significantly differ among the various accounting and governance academic studies and regulatory principles, but they usually depend upon the ability to influ-ence contractual terms and conditions. The topic has been neglected for a long time. In the literature two theories prevail: (a) conflict of interests, considering these dealings as potentially harmful and carried out in the interest of directors; (b) efficient transaction hypothesis, describing them as sound economic exchanges. The paper examines both theories critically through a deductive approach, and also on the basis of their economic rationale. Then, a contingency perspective is suggested, underling how the effectiveness and the efficiency of the proposed solutions are strictly correlated to organizational contexts, institutional environments and governance practices. The study is largely based on a literature review and has different purposes: (a) to shed light on a topic, that, despite its potential impact, has not yet deserved great attention in governance studies; (b) to stress possible inconsistencies in the above mentioned theories, both, to some extent, ideologically biased and unable to offer a proper picture of these heterogeneous dealings; (c) to suggest a more balanced and pragmatic approach, less influ-enced by a suspicious attitude (typical of the conflict of interests theory), possibly more consistent with their economic rationale (as suggested by the efficient transactions hypothesis) as well as social fac-tors and governance practices.     

Strategic planning—A contingency approach—Part 1. The strategic analysis

This article emphasizes a certain approach to business strategy formation exercise, i.e. the adaptive mode. As the 1970s emerge into the uncertain 1980s, and as sophisticated extrapolation is becoming increasingly valueless, there is an even greater case for business planning with the required degree of responsiveness built into it. The authors support this case from literature survey and an actual case study. This is the first of two articles on this subject.     

The strategic role of Human Resource Development in managing core competencies

The Resource-Based View (R-BV) of strategy emphasizes the importance of core competencies as the critical basis for sustainable competitive advantage. Yet, discussions of strategy typically ignore the role of the Human Resource Development (HRD) function in core competency development and management. The literature on strategic HRD is reviewed to locate the R-BV as a basis for redefining HRD's role in organizational strategy. Three strategic roles for the HRD function in core competency management are proposed and discussed: participating in strategic planning, developing core competencies, and protecting them. Specific tasks for each role are proposed. The final section identifies needs for further research as well as the practical implications from this discussion.     

The angry physician--Part 2. Managing yourself while managing others

One of the most difficult aspects of physician leadership is addressing angry colleagues. The first article in this series called attention to the problems that come with the Type A coping styles of many physicians and outlined strategies for managing oneself. Part 2 provides specific strategies that can be helpful in managing others' anger-generating behaviors and anger reactions. There are eight practical communication guidelines recommended by experts in the field for managing anger in others. They include: Strike while the "iron is warm." Match, then lead. Stay in your own zone. De-escalate the other's angry reactions. Do something different. Be assertive, not aggressive. Use effective negotiation tactics. Operationalize the problem.     

Strategies in managing turnaround

This article describes the development of the Scandinavian colour TV industry during the 1970s. It examines strategies of six Scandinavian firms during the rapid expansion phase 1970–1976 and the saturation phase 1976–1978. Most of the Scandinavian firms went into severe crisis in the end of the 1970s and their survival strategies are also presented. The article also discusses the general implications of the case. To understand strategic processes in industrial firms we must know what freedom of action each firm had in its field. Also, the formulation of different strategies must be seen as a result of the internal organizational structure in each firm, in terms of corporate culture, style of leadership, etc. Strategic actions and organizational changes are inseparable parts of the same development process.     

Firm reputation and investment decisions: The contingency role of securities analysts' recommendations

Moving beyond resource-based consequences of a firm's reputation, we develop a behavioral perspective on the impact of corporate reputation. Although there has been extensive discussion in previous studies of the benefits of reputation in terms of gaining resource advantages, we apply theory on self-regulatory focus to suggest that highly reputable firms may tend to have a prevention focus rather than a promotion focus in their investment strategies. This tendency will lead the firm to opt for low-risk investments rather than high-risk investments. Furthermore, we develop a contingency model and argue that the main effect of reputation on the investment decisions of the firm is further strengthened by the negative recommendations of securities analysts. We find support for our hypotheses. In doing so, we address emerging theories about the potential negative consequences of a firm's reputation and provide important insights for our theoretical understanding of the behavior of highly reputable firms.     

Strategic planning—A contingency approach—Part 2. The plan

This is the second article on the subject of the adaptive approach to business strategy formation exercise and illustrates the approach with a case study. Part 1 appeared in the August 1983 issue of the Journal.     

Key issues in managing information

In this article data, information and state of knowledge are described and then related to the decision-making process. The theme that data is a valuable commodity needing management is then developed. Then follows a section on computers, organizational policies and central and distributed processing. Some contractual aspects relating to procurement are described. Examples are given of actual applications in British industry, followed by discussion of two different issues, namely privacy and computer crime. The author draws the conclusion that ‘information’ per se is a personal, corporate and management asset which needs proper understanding and management in the computer era.     

Brief case: managing inputs

Jane Carmichael's views on Managing Inputs provide a further interesting contribution on a topic, strategic control, that we have covered on several occasions in this column. Carmichael's approach is to dig back behind the results being achieved to the 'inputs' on which they depend. But, while this may unearth causes of performance that can often be missed by a bottom-line orientation, results must ultimately remain vital; a business that is on track with all its input measures, but is missing its output goal is still in trouble. We continue to be interested in hearing from readers with views on strategic control processes, particularly those who have found productive ways of setting input and output targets.     

Measuring bill-of-material accuracy: Practicalities and pitfalls

This paper reports on the findings of a bill-of-material audit carried out in the Manchester Transmission plant of Eaton Corporation. From the audit, the major sources of bill-of-material inaccuracies were identified, quantified and described. It is concluded that the accuracies of bill-of-material content and structure, although closely inter-related, cannot be aggregated into one overall measurement. This is because structural errors are insidious and tend to inhibit commercial flexibility, whereas content errors have an immediate tangible impact on production. Although the original objective, to obtain a single measure of bill-of-material accuracy, was not achieved, there were nevertheless several benefits arising from the audit: specific bill-of-material errors were identified and rectified; awareness within the company of the importance of bill-of-material accuracy was improved; inefficiencies in the processing of engineering changes were identified. The audit directly led to the development of a process for restructuring the company's bills of material, and a company engineering change procedure.     

A contingency approach to resource‐creation processes

The resource‐based view has provided valuable insights into sources of competitive advantage, but little attention has been paid to the processes of resource creation. To address this shortcoming, this paper reviews the strategy process literature, explaining the theoretical positions and assumptions that underpin different types of process. It then examines the mechanisms by which resources have been found to be created; luck, resource picking, internal development and alliances. Next, a series of resource‐creation pathways that illustrate the different routes firm inputs might take on the way to becoming unique and valuable resources is developed. These pathways are also discussed in terms of the strategy processes through which they are developed, and the appropriate resource‐creation processes. The review is then extended with the introduction of two contingent variables ? task complexity and environmental stability – and the resource‐creation processes that are congruent with different combinations of these variables are explored. From this review, one is able to identify the combination of complex task and stable environment likely to be the most conducive to resource creation. Finally, the paper explores opportunities that firms might have to engineer stability and complexity in some parts of their operations with the aim of developing a resource‐based advantage.     

Nutrient intake in day workers and shift workers

Abstract

The 24-h dietary intake, nutritional status parameters and psychosomatic factors of two-shift, three-shift and day workers were compared. Estimations of the dietary intake (across a work cycle) were made by use of a nutrient database. No significant differences were found between the groups for a large number of nutritional variables: intake of energy; intake and percentage of energy from protein, fat, total carbohydrates and sucrose; intake of coffee; and intake and density of vitamins and minerals. Only minor differences were found between the groups with regard to the quantitative intake of alcohol and calcium, and with regard to the quality of the diet (percentage of energy from alcohol, density of calcium). The groups differed significantly with respect to attitude towards work hours (three-shift workers being most negative in their attitude) and sleep disturbances (shift workers being most negative). The three-shift workers were more evening-oriented and they had higher concentrations of glucose in their blood. It was concluded that work hours not related to nutritional intake—at least not when total amounts across time are considered. It was also concluded that work hours were not related to Body Mass Index or blood lipids: triglycerides, total cholesterol, LDL (low-density lipoprotein) cholesterol and HDL (high-density lipoprotein) cholesterol.     

Nutrient intake in day workers and shift workers

The 24-h dietary intake, nutritional status parameters and psychosomatic factors of two-shift, three-shift and day workers were compared. Estimations of the dietary intake (across a work cycle) were made by use of a nutrient database. No significant differences were found between the groups for a large number of nutritional variables: intake of energy; intake and percentage of energy from protein, fat, total carbohydrates and sucrose; intake of coffee; and intake and density of vitamins and minerals. Only minor differences were found between the groups with regard to the quantitative intake of alcohol and calcium, and with regard to the quality of the diet (percentage of energy from alcohol, density of calcium). The groups differed significantly with respect to attitude towards work hours (three-shift workers being most negative in their attitude) and sleep disturbances (shift workers being most negative). The three-shift workers were more evening-oriented and they had higher concentrations of glucose in their blood. It was concluded that work hours not related to nutritional intake—at least not when total amounts across time are considered. It was also concluded that work hours were not related to Body Mass Index or blood lipids: triglycerides, total cholesterol, LDL (low-density lipoprotein) cholesterol and HDL (high-density lipoprotein) cholesterol.     

Enterprise governance and value-based management: a theoretical contingency framework

In an attempt to provide a better understanding of the tension between conformance and performance in the governance context, this study develops a conceptual model for enterprise governance (EG) from the contingency theory perspective. The study argues that the value-based management (VBM) approach can achieve the objectives of EG, keeping the right balance between conformance and performance. Therefore, the study investigates the implications of fit between four contingency factors and VBM on organisational performance using corporate governance (CG) mechanisms and corporate entrepreneurship as mediating factors. The study contributes to the literature by linking a performance management system, i.e. VBM, to the EG framework aiming to bridge the gap between management accounting, CG, and entrepreneurship disciplines.     

From managing access to managing care: the impact of primary care on health care delivery organizations.

Professional "revenge of the nerds" is currently taking place, as managed care evolves generalist physicians into new professional prominence. Primary care physicians are finding themselves at the center of health care market reform as health plans, insurers, and other financing organizations turn to them as the key to cost control. In short supply, they are prospering financially from the demand. As the source of patients, they are gaining in prestige from specialists and hospitals who once demeaned them. But these newfound roles are only the initial steps in the transformation of the primary care practitioner. The change that the generalists are experiencing is essentially managing access to care, not truly managing care itself. There are large and crucial differences between managing access to care and actually managing care. These differences are, in many ways, a higher calling for primary care practitioners as they refocus attention on patient outcomes, which will in itself result in a lower resource utilization above and beyond the crude controlling of access. What those differences are, what new roles they require, and what impact they will have on organizations that either house or contract with primary care physicians will be the focus of this article.